tag:blogger.com,1999:blog-4642274826047849093Tue, 05 Feb 2019 12:06:45 +0000CBTdepressionsocialisationbeckcompassionmindfulnessworryCBT songsGADJudith BeckOCDanxietybehavioural experimentscftcognitive therapycompassion focussed therapyfree cbt resourcesguided discoveryhow to do CBThumourmeditationpaul gilbertpositive psychologyskillsstrengthsBABorkovecCBT LondonCBT for personailty disordersCBT videosObsessive-CompulsiveRFCBTSalkovskisWhat is CBTagenda settingassessmentbreak free from OCDcase conceptualisationcbt coursecbt for counsellorscbt interviewcheckingchris ironscognitive behavioural therapycognitive principlecognitive therapy londoncore beliefscts-rdbtdialectical behaviour therapydiffusiondonald robertsondressed watkinsengagementexistentialfirst sessionflowformulationfree downloadsfunctional analysisguilthistory of CBThow not to do CBTillusionsintrusive thoughtsjealousyloving kindnesslow self-esteemmeasuresmediation downloadsmetacognitivemusicpassing cts-rpersonality disordersphilosophical cbtpoisoned parrotpositive data logproblem-solvingrelationshipsresilienceruminationschemasself-attackself-esteemseligmansimilessocrating questioningsongsstoicismsupervisionsuspiciontheapist tipstherapeutic alliancethird wave cbtthird-wave CBTthoughts are not factstim lebon teachingtipswashingwhat has gone well exerciseworksheetsCBT for TherapistsArticles for therapists and counsellor about CBT - Cognitive Therapy. These posts are intended to help the beginning CBT practitioner and also provide food for thought for experienced cognitive therapists. Provided by UKCP Central London therapist and accredited CBT practitioner and supervisor Tim LeBon.http://cbtfortherapists.blogspot.com/noreply@blogger.com (Tim LeBon)Blogger42125tag:blogger.com,1999:blog-4642274826047849093.post-5124486878465886579Thu, 10 Jan 2019 08:44:00 +00002019-01-12T16:42:56.095+00:00cbt coursecbt for counsellorscognitive therapy londontim lebon teaching9 weeks course in London to consolidate your CBT skills<ol class="products-list sli_container " data-sli-selector="products-container" data-tb-cid="9ab1e500-68c3-11e6-9708-132f75d07989" data-tb-pid="9afecc80-68c3-11e6-9708-132f75d07989" data-tb-sid="st_results-container" id="products-list" style="background-color: white; box-sizing: border-box; list-style: none; margin: 0px; padding: 0px;"><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; color: #58595b; font-family: &quot;avenir next w02&quot;, sans-serif; font-size: 12px; margin: 0px; padding: 0px 0.75rem; width: 600px;"><h2 style="font-size: 22px; margin: 0px; position: relative;"><a href="https://4.bp.blogspot.com/-JsHO0v_-8MQ/W4uNYrFQ3vI/AAAAAAABJWI/1HUNNdJ_X90WOxd2aBn_hXhtSZXbYTfxgCLcBGAs/s1600/citylit.png" imageanchor="1" style="clear: left; color: #33aaff; display: inline; font-size: 12px; margin-bottom: 1em; margin-right: 1em; text-align: center;"><img border="0" data-original-height="119" data-original-width="238" height="100" src="https://4.bp.blogspot.com/-JsHO0v_-8MQ/W4uNYrFQ3vI/AAAAAAABJWI/1HUNNdJ_X90WOxd2aBn_hXhtSZXbYTfxgCLcBGAs/s200/citylit.png" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 1px solid rgb(238, 238, 238); box-shadow: rgba(0, 0, 0, 0.1) 1px 1px 5px; padding: 5px; position: relative;" width="200" /></a></h2></li><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; color: #58595b; font-family: &quot;avenir next w02&quot;, sans-serif; font-size: 12px; margin: 0px; padding: 0px 0.75rem; width: 600px;"><h2 style="font-size: 22px; margin: 0px; position: relative;"><a href="https://www.citylit.ac.uk/courses/cbt-for-therapists-and-counsellors" target="_blank">CBT For Counsellors and Therapists</a></h2></li></ol><ol class="products-list sli_container " data-sli-selector="products-container" data-tb-cid="9ab1e500-68c3-11e6-9708-132f75d07989" data-tb-pid="9afecc80-68c3-11e6-9708-132f75d07989" data-tb-sid="st_results-container" style="background-color: white; box-sizing: border-box; list-style: none; margin: 0px; padding: 0px;"><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><span style="color: #58595b; font-family: &quot;avenir next w02&quot; , sans-serif;"><br /></span></li><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><span style="color: #58595b; font-family: &quot;avenir next w02&quot; , sans-serif;">If you are a counsellor or therapist and would like to learn more about CBT then this is a good way to learn it. No knowledge of CBT is assumed, though you should be willing to devote a couple of hours a week to study and practice as well </span><span style="color: #58595b;"><span style="font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;">as attending classes.&nbsp; &nbsp;This is what we plan to cover:-</span></span></li></ol><span style="color: #58595b; font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;"><br /></span><br /><div><div style="background-color: white;"><span style="font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;"><span style="color: #58595b;">•<span style="white-space: pre;"> </span>What is CBT?&nbsp;&nbsp;</span></span></div><div style="background-color: white;"><span style="color: #58595b; font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;">•&nbsp; &nbsp; &nbsp; &nbsp;</span><span style="font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;">Formulation and Case Conceptualisation&nbsp; in CBT</span></div><div style="background-color: white;"><span style="color: #58595b; font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;">•<span style="white-space: pre;"> </span>Guided Discovery &amp; Socratic Questioning</span></div><div style="background-color: white;"><span style="color: #58595b; font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;">•<span style="white-space: pre;"> </span>Cognitive Techniques&nbsp;</span></div><div style="background-color: white;"><span style="color: #58595b; font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;">•<span style="white-space: pre;"> </span>Behavioural Techniques</span></div><div style="background-color: white;"><span style="color: #58595b; font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;">•<span style="white-space: pre;"> </span>CBT for Depression</span></div><div style="background-color: white;"><span style="color: #58595b; font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;">•<span style="white-space: pre;"> </span>CBT for Panic</span></div><div style="background-color: white;"><span style="color: #58595b; font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;">•<span style="white-space: pre;"> </span>CBT for Worry</span></div><div style="background-color: white;"><span style="color: #58595b; font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;">•<span style="white-space: pre;"> </span>CBT for Anger</span></div><div style="background-color: white;"><span style="color: #58595b; font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;">•<span style="white-space: pre;"> </span>Consolidating your CBT practice.</span></div><ol class="products-list sli_container " data-sli-selector="products-container" data-tb-cid="9ab1e500-68c3-11e6-9708-132f75d07989" data-tb-pid="9afecc80-68c3-11e6-9708-132f75d07989" data-tb-sid="st_results-container" style="background-color: white; box-sizing: border-box; list-style: none; margin: 0px; padding: 0px;"><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><span style="color: #58595b; font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;"><br /></span></li><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"></li></ol></div><ol class="products-list sli_container " data-sli-selector="products-container" data-tb-cid="9ab1e500-68c3-11e6-9708-132f75d07989" data-tb-pid="9afecc80-68c3-11e6-9708-132f75d07989" data-tb-sid="st_results-container" style="background-color: white; box-sizing: border-box; list-style: none; margin: 0px; padding: 0px;"><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><span style="color: #58595b; font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;"><br /></span></li><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><span style="color: #58595b; font-family: &quot;avenir next w02&quot; , sans-serif;">I have been teaching CBT for over 20 years and also provide supervision for CBT practitioners. I regularly practice CBT in the NHS and in private practice and am a BABCP accredited CBT therapist.&nbsp; I am enthusiastic about CBT and particularly enjoy helping counsellors new to CBT to learn more about it.</span></li></ol><div><br /></div><div><ol class="products-list sli_container " data-sli-selector="products-container" data-tb-cid="9ab1e500-68c3-11e6-9708-132f75d07989" data-tb-pid="9afecc80-68c3-11e6-9708-132f75d07989" data-tb-sid="st_results-container" id="products-list" style="background-color: white; box-sizing: border-box; list-style: none; margin: 0px; padding: 0px;"><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><span style="color: #262626; font-family: &quot;avenir next w02&quot; , sans-serif; font-size: 16px;"><br /></span></li><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><div class="product-shop sli_generic_container" data-tb-cid="afdcc249-95c6-4dc4-9fbd-c2fc5de6ad2e" data-tb-pid="3c05f380-46d9-11e7-bcf0-e550155862dc" data-tb-sid="st_container" style="border-top: 1px solid rgb(209, 211, 212); box-sizing: border-box; float: none; margin: 0px; padding: 1.5rem 0px; width: 600px;"><div class="product-text-wrapper sli_generic_container" data-tb-cid="a6f7b101-9c7d-4d04-9382-b28b4a59ddff" data-tb-pid="a2346600-46d9-11e7-8243-c569e69126ea" data-tb-sid="st_container" style="box-sizing: border-box; float: none; margin: 0px; padding: 0px; width: 600px;"><div class="product-primary sli_generic_container" data-tb-cid="0330d231-ceab-4f4b-90f2-2b01cd8c1b49" data-tb-pid="c332bfa0-46d9-11e7-8243-c569e69126ea" data-tb-sid="st_container" style="box-sizing: border-box; float: left; height: 211px; margin: 0px; overflow: visible; padding: 0px 0.75rem 0px 0px; width: 426.987px;"><div class="product-essential columns-8" style="box-sizing: border-box; float: left; margin: 0px; padding: 0px 0.75rem; width: 600px;"><div class="product-shop" style="box-sizing: border-box; margin: 0px; padding: 0px;"><div class="std" style="box-sizing: border-box; margin: 0px; padding: 0px;"><div style="box-sizing: border-box; margin: 0px; padding: 0px;"><div><div><span style="color: #262626; font-family: &quot;avenir next w02&quot; , sans-serif; font-size: 16px;">Course Dates:&nbsp;</span><span style="color: #262626; font-family: &quot;avenir next w02&quot; , sans-serif; font-size: 16px; font-weight: 700;">24/01/19 - 28/03/19 (no class 21/02) Thursday evenings</span></div><div class="std" style="box-sizing: border-box; color: #262626; font-family: &quot;avenir next w02&quot;, sans-serif; font-size: 16px; margin: 0px; padding: 0px;"><div class="course-information" style="box-sizing: border-box; margin: 0px; padding: 0px;">Time:&nbsp;<span style="box-sizing: border-box; font-weight: 700; margin: 0px; padding: 0px;">18:00 - 21:00&nbsp;</span><br />Location:&nbsp;<span style="box-sizing: border-box; font-weight: 700; margin: 0px; padding: 0px;">Keeley Street,Central London, near Convent Garden &amp; Holborn.</span></div></div></div><a href="https://www.citylit.ac.uk/courses/cbt-for-therapists-and-counsellors" style="color: #58595b; font-family: &quot;avenir next w02&quot;, sans-serif; font-size: 0.9em;" target="_blank"><b>Read review</b></a><br /><span style="background-color: #cc569d; color: white; font-family: &quot;avenir next w02&quot; , sans-serif; font-size: 14px;">Call City Lit Enrolments line:&nbsp;</span><a class="rTapNumber268818" href="tel:+442080237740" style="background-color: #cc569d; box-sizing: border-box; color: white; font-family: &quot;avenir next w02&quot;, sans-serif; font-size: 14px; margin: 0px; padding: 0px; visibility: visible;">020 8023 7740</a></div></div></div></div></div></div></div></li><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><a class="rTapNumber268818" href="tel:+442080237740" style="background-color: #cc569d; box-sizing: border-box; color: white; font-family: &quot;avenir next w02&quot;, sans-serif; font-size: 14px; margin: 0px; padding: 0px; visibility: visible;"><br /></a></li><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><span style="color: #262626; font-family: &quot;avenir next w02&quot; , sans-serif; font-size: 16px;"><br /></span></li><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><span style="color: #262626; font-family: &quot;avenir next w02&quot; , sans-serif; font-size: 16px;"><br /></span></li><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><span style="color: #262626; font-family: &quot;avenir next w02&quot; , sans-serif; font-size: 16px;"><br /></span></li><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><span style="color: #262626; font-family: &quot;avenir next w02&quot; , sans-serif; font-size: 16px;"><br /></span></li><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><span style="color: #262626; font-family: &quot;avenir next w02&quot; , sans-serif; font-size: 16px;"><br /></span></li></ol><div><br /></div></div><div><br /></div><ol class="products-list sli_container " data-sli-selector="products-container" data-tb-cid="9ab1e500-68c3-11e6-9708-132f75d07989" data-tb-pid="9afecc80-68c3-11e6-9708-132f75d07989" data-tb-sid="st_results-container" style="background-color: white; box-sizing: border-box; list-style: none; margin: 0px; padding: 0px;"><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><span style="color: #58595b; font-family: &quot;avenir next w02&quot; , sans-serif;"><br /></span></li><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"></li></ol><br /><br />Here are all the courses I am currently set to offer in 2019.<br /><br />You can see when these are on this handy <a href="https://calendar.google.com/calendar?cid=cDAzZTR2NjU4MzF1cmgybGRwbGtuM2gxNzBAZ3JvdXAuY2FsZW5kYXIuZ29vZ2xlLmNvbQ">calendar</a><br /><br /><iframe frameborder="0" height="400" scrolling="no" src="https://calendar.google.com/calendar/embed?src=p03e4v65831urh2ldplkn3h170%40group.calendar.google.com&amp;ctz=Europe%2FLondon" style="border: 0;" width="600"></iframe> <br /><br /><ol class="products-list sli_container " data-sli-selector="products-container" data-tb-cid="9ab1e500-68c3-11e6-9708-132f75d07989" data-tb-pid="9afecc80-68c3-11e6-9708-132f75d07989" data-tb-sid="st_results-container" style="background-color: white; box-sizing: border-box; list-style: none; margin: 0px; padding: 0px;"><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><span style="color: #58595b; font-family: &quot;avenir next w02&quot; , sans-serif;"><br /></span></li><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><span style="color: #58595b; font-family: &quot;avenir next w02&quot; , sans-serif;"><br /></span></li><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><span style="color: #58595b; font-family: &quot;avenir next w02&quot; , sans-serif;"><br /></span></li><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><div><span style="color: #58595b; font-family: &quot;avenir next w02&quot; , sans-serif;"><br /></span></div></li></ol><div><span style="color: #222222; font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;"><span style="font-size: 10.8px;"><br /></span></span></div><div><span style="color: #222222; font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;"><span style="font-size: 10.8px;"></span></span></div><ol class="products-list sli_container " data-sli-selector="products-container" data-tb-cid="9ab1e500-68c3-11e6-9708-132f75d07989" data-tb-pid="9afecc80-68c3-11e6-9708-132f75d07989" data-tb-sid="st_results-container" style="background-color: white; box-sizing: border-box; color: #222222; font-family: arial, helvetica, sans-serif; font-size: 12px; list-style: none; margin: 0px; padding: 0px;"><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><div style="box-sizing: border-box; font-size: 0.9em; margin: 0px; padding: 0px;"><br /></div></li><li class="item sli_wrapper sli_col1" data-tb-cid="986d3fa0-68d8-11e6-887d-49a70c42e7d2" data-tb-pid="" data-tb-sid="st_result-container-wrapper" style="border: 0px; box-sizing: border-box; margin: 0px; padding: 0px 0.75rem; width: 600px;"><div><span style="box-sizing: border-box; font-weight: 700; margin: 0px; padding: 0px;"><br /></span></div></li></ol><br /><a href="https://www.citylit.ac.uk/courses/cbt-for-therapists-and-counsellors" target="_blank">https://www.citylit.ac.uk/courses/cbt-for-therapists-and-counsellors</a><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
Visit http://www.timlebon.com/consultations.htm
Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2019/01/cbt-for-counsellors-and-therapists-if.htmlnoreply@blogger.com (Tim LeBon)1tag:blogger.com,1999:blog-4642274826047849093.post-7765260408965001178Sun, 28 Oct 2018 07:38:00 +00002018-10-28T07:38:15.050+00:00assessmentfirst sessiontheapist tips8 things to do in the first session of CBT1. Do the usual things that need to happen in a therapy assessment. unless they you already have this information. The information you need&nbsp; includes&nbsp; demographics, previous psychological interventions, family history, medication and lifestyle (diet, exercise, alcohol and drug use) . Since these are not specific to CBT, in my view its a good idea for a service to elicit this information for all clients so that your first session can focus on the CBT. If you work in private practice, you might decide to ask for this information by email or in a quick phone call. If you haven't got this information before the first appointment, you need to allow extra time for the first session otherwise you won't get much CBT done. If you don't get much CBT done in the first session, the danger is the client won't come back because nothing useful has happened in the first session.<br />2. Read all the information you have about the client before you meet them. This need take no longer than 5 minutes.. I will never get going with my son for an appointment to his allergy clinic. The doctor, who had actually seen him before, clearly remembered nothing about him and had to ask all the basic questions again Two minutes reviewing her notes would have made all the difference. What message does it give if&nbsp; a patient&nbsp; if the therapist doesn't&nbsp; know basic things about you that you have already told them (or someone else in their service)?<br />3. Do an MDS (including PHQ9 for depression and GAD7 for anxiety) and a risk&nbsp; assessment. Ask about risk even if this has been done in a prior call as it may have changed. When doing the MDS, its worth asking for specifics as this gives you extra information. for example if they have answered yes to the question positively to the question about sleep, ask whether its sleeping too little, too much or not getting or staying asleep. For this reason, in the first session I prefer to ask them the questions rather than have them fill it in, though in subsequent sessions it saves time if patients fill in the MDS before the session..<br />4. Socialise the patient into CBT. I have written <a href="http://cbtfortherapists.blogspot.com/2013/06/how-to-engage-and-socialise-clients.html" target="_blank">another post to suggest good ways to do this</a>. This is an important part of the first session, especially for clients who have had a different form of therapy before (in which case you might need to emphasise the difference) or have had no therapy.<br />5. Find out their initial problems and goals.&nbsp; I see the problem as being the clinical window on their treatment - such as depression, anxiety, OCD or social anxiety.&nbsp; Goals are the client's view of what they want from CBT. These will often typically be expressed as "Feel like I used to" or "Be happy" in which case you need to spend some time getting the goals into shape. At this stage, they don't have to be fully SMART but here are 2 rules I follow for initial goal-setting.<br />a) Make sure they are positive - if someones says "not feel depressed" ask "what will you be doing once you are not depressed?"<br />b) Make sure they are behavioural. If a patient says "I want to feel happy" ask "once you are happy, what would a fly on the wall notice you doing differently"<br />Ask about which is the most urgent and important problem for them to work on.<br />6. Do an initial&nbsp; formulation. This will often be a five areas model or hot cross bun on the main problem. For any PWPS reading this, you can use the problem statement to the same effect.<br />For instance, if someone says that the main problem is depression, then do a five areas assessment of depression.&nbsp; There are 3 very good reasons for doing this<br />a) It further socialises the patient into CBT. They go in to the session knowing they are depressed, they come out realising that their behaviours, avoidance and thinking is whats keeping them depressed<br />b) It aids your treatment plan. Its always tempting to launch into treatment before the formulation but think about it - it would be like your dentist deciding on treatment before getting the x-ray results.<br />c) It aids collaboration and reduces resistance. Most of this initial session is information-gathering or information-giving. This is the part where you start working together on the problem<br />If the problem is known to be one for which we have a good disorder specific model, there is a strong case for launching straight into the disorder specific model. For example with panic you could go straight to Clarks model. If you stick with the 5 areas model in the first session, then make sure you ask questions informed by the model - such as "What do you notice going on in your body when you start to feel anxious?" and "What thoughts do you have about what is going on in your body?"<br />7. Set appropriate homework (which I prefer to call home practice or better still daily practice)<br />This should follow naturally from what has happened in the session. Examples of potentially good homework might be<br />a) working on making the goals smarter<br />b) Reading psycho-educational material (for example about fight/flight reaction)<br />c) taking away a copy of ihe initial 5 areas formulation and reviewing it<br />d) keeping a 5 areas diary relating ot the problem being prioritised<br />e) If you sense ambivalence, asking the patient to write down the pros and cons for working on this<br />8 Elicit feedback on the session.&nbsp; How did you find this session" and "What was the most important thing you will take from it"&nbsp; and "How do you think CBT could help you?" are good questions.<div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
Visit http://www.timlebon.com/consultations.htm
Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2018/10/8-things-to-do-in-first-session-of-cbt.htmlnoreply@blogger.com (Tim LeBon)5tag:blogger.com,1999:blog-4642274826047849093.post-7766257906546042695Sun, 26 Nov 2017 14:48:00 +00002018-10-28T06:51:18.313+00:00positive psychologystrengthssupervisionwhat has gone well exerciseA small thing that could make a big difference if you supervise anyone<div class="separator" style="clear: both; text-align: center;"><a href="https://4.bp.blogspot.com/-R_mXaEYxS80/WhswKmfyAFI/AAAAAAABFqA/2XVUES_6XK0NNk1soYNNxIMxhFocNENswCLcBGAs/s1600/whatsgonewell.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="172" data-original-width="832" height="66" src="https://4.bp.blogspot.com/-R_mXaEYxS80/WhswKmfyAFI/AAAAAAABFqA/2XVUES_6XK0NNk1soYNNxIMxhFocNENswCLcBGAs/s320/whatsgonewell.jpg" width="320" /></a></div><br /><br />Do you supervise anyone as part of your clinical work?<br /><br /><br />Even if you do not think of yourself as a supervisor, you may find that as part of your work you do in effect take on&nbsp; a supervisory role.<br /><br />For example you may<br />* Do case management of a number of colleagues in an IAPT service<br />* Shadow trainees and provide feedback<br />* Be part of a supervision group, in which you are at times required to provide feedback<br />* Engage in peer supervision<br /><br />Are you supervised yourself? Would you agree that being supervised can be quite stressful? Have you ever felt criticised in supervision? Have you ever felt really stressed, angry or upset during supervision? Have you ever&nbsp; chosen <i>not to&nbsp;</i>share a case for fear of how the supervisor or your colleagues would respond?<br /><br />If you have answered "yes" to any of these questions then join the club. I can answer "yes" to every one of these questions. Although it isn't often talked about, supervision can be a scarey place, where you lay open your soul and hope for the best.<br /><br />It needn't be like this, though. Supervision can be a positive,&nbsp; interesting, exciting, compassionatesetting for learning about what you do well as well what can be improved in your clinical work. As a supervisor, I find it very helpful to remember this especially when I notice a critical voice about to enter my head.<br /><br />Whilst&nbsp; positive supervision is of course&nbsp; best expressed in the whole spirit in which you conduct supervision, there is one small thing I've introduced into my clinical practice&nbsp; as a supervisor which I believe makes a big difference. It's this.<br /><br /><br /><br />At the start of each session, I ask each supervisee a simple question<br /><br />"Share with us one thing that has gone well in your work since we last met"<br /><br />Often the supervisee has to think for a while, and then they come up with something. Maybe a difficult case that's gone surprisingly well, perhaps a difficult situation with colleagues that was resolved, sometimes an initiative they have introduced in the service or their private practive or a course they have delivered well.<br /><br />As we discuss this the supervisee's&nbsp; body language lifts and the atmosphere in the room becomes more relaxed and positive.<br /><br />But that's not all. I then ask<br /><br />"What did you do, what quality did you show, that helped make this thing go so well?"<br /><br />Sometimes the supervisee will struggle to identify what it was exactly, in which case you can help them figure it out. More often than not though, they will be able to say "I was empathic", "I prepared well" or "I was assertive" or whatever it was that helped. Again, they will be pleased and the atmospher will lift.<br /><br />Even more importantly you and they are learning about their strengths as a therapist. You can&nbsp; feed their strengths&nbsp; back to them in moments when they appear to be&nbsp; doubting themelves. You can ask them if they can use the qualities they have identied as helping in the "What's gone well" exercise when they come to present cases they are struggling with. You can help them build a profile of their strengths as a therapist.<br /><br />Why not give "What's gone well" a go the next time you supervise someone? Let us know whether you find it helpful, in the comments section below.<div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
Visit http://www.timlebon.com/consultations.htm
Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2017/11/a-small-thing-that-could-make-big.htmlnoreply@blogger.com (Tim LeBon)7tag:blogger.com,1999:blog-4642274826047849093.post-6610349358404918547Sun, 24 Jul 2016 21:27:00 +00002016-07-25T01:03:07.184+01:00BACBTdepressionCBT or BA for depression? The verdict is in!<br />In 2015 I attended a talk at the BABCP conference given by Dave Richards telling us all about<a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31140-0/abstract" target="_blank"> COBRA</a>, a very large scale research project aimed at &nbsp;determining whether stand-alone Behavioural Activation (BA) could be recommended as strongly as CBT for depression. The current <a href="https://www.nice.org.uk/guidance/cg90?unlid=4306996020163922547" target="_blank">NICE guidelines for Depression</a> recommend CBT over BA - which, &nbsp;whilst understandable given the sheer <i>quantity </i>of evidence for CBT - seemed to me a recommendation waiting to be revised. &nbsp;Having used both BA and standard CBT for depression, I have found &nbsp;BA components to be &nbsp;very powerful.<br />Of course NICE can't recommend treatments on such clinical impressions. They need &nbsp;hard evidence.<br />Enter COBRA - a massive 4 year, 440 participant study to test out whether depressed patients fared better with standard CBT or BA. &nbsp;By 2015 many of the preliminary results were in, but Richards was not allowed to tell us anything about them at the BABCP conference.<br /><br />Now the wait is over and the result is that<br /><br /><b>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; BA was found to be not inferior to CBT for depression</b><br /><br />The wording is important - to encourage NICE to make BA an equal treatment of choice to CBT next time it updates its guidance for depression, the focus was on BA being as good as standard CBT. &nbsp; The authors of the study hope that this finding will make treatment for depression more affordable, since BA can be provided by practitioners with less experience and for less money than fully qualified CBT practitioners. &nbsp;The question I want to consider here is a different one. &nbsp;How can COBRA help us &nbsp;CBT practitioners o become more effective in treating depression. &nbsp;You might like to read the full report <a href="http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31140-0.pdf" target="_blank">here</a>&nbsp;and come up with your own thoughts ...<br /><br />Here are three things I take from the report ....<br /><br /><b>1) Learn more about &nbsp;Behavioural Activation</b><br />The BA protocol used &nbsp;in COBRA was described as follows :-<br /><br /><blockquote class="tr_bq">[BA Practitioners] delivered an individually tailored programme re-engaging participants with positive environmental stimuli and developing depression management strategies. Participants were encouraged to increase their contact with individually specified positive situations and reduce their avoidance of other situations. Specific BA techniques included identification of depressed behaviours, analysis of the triggers and consequences of depressed behaviours, monitoring of activities, development of alternative goal-orientated behaviours, scheduling of activities, and development of alternative behavioural responses to rumination</blockquote><br />So BA is much more than just scheduling positive activities. It involves quite sophisticated functional analysis of depression and teaching of goal-orientated behaviours and anti-rumination techniques.<br /><div>A number of good books are available to learn more - I would recommend</div><div><a href="https://www.amazon.co.uk/dp/1845293142/ref=pd_lpo_sbs_dp_ss_2?pf_rd_p=569136327&amp;pf_rd_s=lpo-top-stripe&amp;pf_rd_t=201&amp;pf_rd_i=160623515X&amp;pf_rd_m=A3P5ROKL5A1OLE&amp;pf_rd_r=QNJG62QXDKYQRBC87NBP" target="_blank">Manage your Mood by Robb Wilson and David Veale </a>&nbsp;as a self-help book and</div><div><a href="https://www.amazon.co.uk/Behavioral-Activation-Depression-Clinicians-Guide/dp/160623515X" target="_blank">Behavioural activation &nbsp;for depression: A clincians Guide </a>by Chris Martell et al. for therapists.</div><br />A good &nbsp;brief introduction on the web can be found<a href="http://apt.rcpsych.org/content/14/1/29" target="_blank"> here</a><br /><br /><b>2) Incorporate BA techniques into your standard CBT treatment</b><br /><br />The "standard CBT" protocol excluded some of &nbsp;behavioural techniques that might easily be included into your CBT treatment for depression.<br /><br /><blockquote class="tr_bq">[CBT Practitioners]&nbsp;delivered a personalised treatment programme based on an assessment of how participants’ beliefs lead to emotional distress and ineffectual coping. Participants used cognitive and behavioural exercises to specifically test the accuracy of those beliefs by identifying and modifying negative thoughts and beliefs that give rise to them. Specific techniques included participants monitoring moods and activities, planning of exercises to test negative beliefs, and thought records to identify and examine the accuracy of negative automatic thoughts and underlying beliefs&nbsp;</blockquote><br /><br />The CBT delivered appears to have been very cognitive, with the main behavioural compoment being behavioral experiments to test out beliefs.<br /><br />There appears to be plenty of scope for incorporating more behavioural strategies into your CBT treatment - especially activity scheduling and <a href="http://cbtfortherapists.blogspot.co.uk/2013/02/10-things-i-learnt-from-ed-watkins-cbt.html" target="_blank">anti-rumination techniques</a>. Personally I have found that focussing on rumination has greatly benefitted many sufferers of depression.<br /><br /><b>3) &nbsp;Develop an individualised formulation to decide whether to focus more on behavioural or cognitive methods</b><br /><b><br /></b>Good CBT is driven by an individualised formulation. Is your client depressed mainly because they are thinking negatively or because they have lost contact with enjoyment and a sense of achievement? Are they ruminating a lot? &nbsp;Have they lost a sense of purpose? Is a negative view of themselves, the world and the future at the heart of their depression? &nbsp;Do they know how to problem solve and set SMART goals? &nbsp;Are they falling prey to a &nbsp;lot of thinking traps? These and other questions (asked in assessment) can give you a good sense of where to focus your treatment. Your formulation can help you summarise this understanding of their depression and help you make the quickest wins<br />Of course, cognitive change can bring about behavioural change and vice-versa, so you probably dont have to go through every behavioural ("outside-in") and cognitive ("inside-out") strategy to achieve improvement. The idea here is to work out which element is causing the biggest problems and target that first.<br />The COBRA study does not directly provide evidence that such an approach would be superior to either BA or CBT as per the protocols followed. &nbsp; However, it would appear to make a lot of sense.<br />What do you think?<br /><br /><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
Visit http://www.timlebon.com/consultations.htm
Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2016/07/cbt-or-ba-for-depression-verdict-is-in.htmlnoreply@blogger.com (Tim LeBon)3tag:blogger.com,1999:blog-4642274826047849093.post-149342690377720092Sat, 27 Feb 2016 15:34:00 +00002016-02-27T15:34:03.209+00:00Quiz - CBT for Specific Disorders<div class="quizz-container" data-width="100%" data-height="auto" data-quiz="49620"></div><script src="//dcc4iyjchzom0.cloudfront.net/widget/loader.js" async></script><a href="https://www.qzzr.com/c/quiz/49620/18fd1a50-0b92-40a7-8d98-337f47d5f684"></a><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
Visit http://www.timlebon.com/consultations.htm
Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2016/02/quiz-cbt-for-specific-disorders.htmlnoreply@blogger.com (Tim LeBon)0tag:blogger.com,1999:blog-4642274826047849093.post-7558828356076038287Wed, 25 Nov 2015 12:33:00 +00002015-11-25T17:38:33.049+00:00CBTdbtdialectical behaviour therapymindfulnessthird wave cbt10 Things I learnt from Fiona Kennedy's Putting DBT into your practice 2 day workshop - Dialectical Behaviour Therapy<div><br />This excellent workshop wasn't intended as a complete training in DBT, but rather as a way to understand how an experienced practitioner could take parts of the DBT model and incorporate it into their practice. It worked for me! Here are the top 10 things I learnt from the course<br /><br /></div><div><div><br /></div></div><div><br /></div><div><h2><b>1) DBT is <i>Dialectical</i></b></h2></div><div><br /><b>Dialectical </b>means accepting and working with opposites and apparent contradictions</div><div>There is a thesis, an antithesis and then a synthes which includes &nbsp;truth from both.<br /><br /><br /><ul><li>For example, &nbsp;if <i>the</i> <i>thesis </i>is&nbsp;<b>"I need to change!"</b>.&nbsp;</li><li>and&nbsp;<i>&nbsp;the antithesis </i>is&nbsp;<b>"I can't change"</b>.&nbsp;</li><li><i>the</i> <i>synthesis</i> could be "<b>Change is difficult. What I have tried so far hasn't worked. I need to work on skills to change, even though this will be difficult".</b></li></ul></div><div>If &nbsp;a client wants to practice midfulness (the thesis) but has a cold and says "I cant do mindfulness today because I have a cold" then as a therapist you might helpful suggest (the synthesis) "Your cold presents you with a great opportunity to practice mindfulness when its harder"<br /><br /><h2><b>2) DBT is <i>Behaviorial</i></b></h2><b><i><br /></i></b>The focus is on<b> behaviours </b>that need to be changed for the client to achieve their goals. &nbsp;This provides a very clear focus and can make the complicated and complex <i>much </i>simpler<br />The therapy focuses on<br /><blockquote class="tr_bq"><b><br /></b><b>What am I doing causing me and others problems and what can I do differently?</b></blockquote><div><b><br /></b><b>Below is a summary of some behavioural principles which can help guide a skilful therapist</b></div><div><ul><li>Form a plan to change unhelpful behaviours</li><li>Get whole lot of possible solutions<ul></ul></li><li>Give them skills ask them to choose like a smorgasbord then ask which appeals most</li><li>Look at obstacles and how to overcome them</li><li>Shape and reward desired action - if they have done something positive, praise this&nbsp;</li></ul></div><h2><b>3) DBT is Skills-based</b></h2>&nbsp;Forming a plan is a good start, but many people don't have the skills to carry this out effectively. There is a large element of skills training in DBT and &nbsp;this is usually done in <b>Skills groups</b><br /><div>where participants &nbsp;learn to decrease problematic and unskillful behaviours.</div><div><div>Each module lasts about 6 weeks</div><div><b>The modules are:</b><br /><div><b>Emotion regulation</b>&nbsp;- what you can change - here are some <a href="http://www.dbtselfhelp.com/html/emotion_regulation1.html" target="_blank">good ideas about emotional regulation</a>&nbsp;and <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3887268/" target="_blank">article assessing cognitive strategies</a> such as distraction and reappraisal</div><div><b>Distress tolerance</b>&nbsp;- dealing with difficult emotions and what you cant change . Here is a useful <a href="http://www.dbtselfhelp.com/html/distress_tolerance_handouts.html" target="_blank">handout on distress tolerance</a>&nbsp; and here are the <a href="http://www.cci.health.wa.gov.au/resources/infopax.cfm?Info_ID=54" target="_blank">CCI modules on distress tolerance</a><br /><b>Mindfulness</b> - learning to control your mind &nbsp;- here is <a href="http://www.dbtselfhelp.com/html/mindfulness1.html" target="_blank">DBT's version of mindfulness</a>&nbsp;and some<a href="http://www.dbtselfhelp.com/html/mindfulness1.html" target="_blank"> free mp3 mindfulness recordings </a>that can be used in DBT<br /><b>Interpersonal skills</b> -learning how to get your needs met regarding other people - here is information on<a href="http://ilovedbt.com/dbt-handouts-worksheets/" target="_blank"> DEAR MAN GIVE FAST</a> ideas and some <a href="http://www.dbtselfhelp.com/html/interpersonal_effectiveness_ha.html" target="_blank">handouts on DBT and interpersonal effectiveness skills</a><br /><br /></div><div>There is typically a maximum of 8 in a group with &nbsp;2 therapists. One talks the other "reads the room"&nbsp;</div><div><div><b><br /></b>As with learning any other skills, homework is key. If people don't do it, this needs to be dealt with.<br /><b>"</b>Did you think of it or did you forget it?". The failure to do homework is problem-solved.<br /><br />Here is a <a href="http://www.bipolarsjuk.se/pdf/Handbook%20in%20DBT%20Group.pdf" target="_blank">really useful free 85 page DBT Skills Booklet</a> that can be used in a group</div></div></div></div></div><div><h2><b>4) A possibly lengthy assessment phase</b></h2></div><div></div><div>DBT is a big investment for both client and therapist. It is fitting then that some time is given for the potential client to think about whether to commit to DBT.<br />A Contract usually a year involving a lot. Asssement will explore motivation and behaviours they want to change. This phase can last up to &nbsp;6 weeks<br /><br /></div><br /><h2><b>5)Telephone coaching is part of the deal</b></h2>In a DBT group, the client is offered &nbsp;telephone coaching when they need it. This is specifically for help when they are in crisis. The client will form a crisis plan which they have with them<br />If they ring, you go through the crisis plan with them<br />"Get them to breathe then walk through plan"<br /><div><div><br /></div><br /></div><div><br /><h2><b>6)Validation and Acceptance of the &nbsp;client</b></h2>Although change is the desired outcome, validation is an extremely important prerequisite for change<br /><br /><b></b>There are&nbsp;<a href="http://www.dbtselfhelp.com/html/validation.html" target="_blank">6 levels of validation</a><br /><br />These range from showing an interest, to validating their emotions and behaviours "It's normal to feel anxious before coming to see a therapist." You are accepting the person, but that doesn't mean you are endorsing unhelpful behaviours.<br /><br /></div><div><br /></div><div><h2><b>7) Use of Chaining as a formulation method&nbsp;</b></h2></div><div>This is similar but not identical to CBT's "<a href="https://www.google.co.uk/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=6&amp;cad=rja&amp;uact=8&amp;ved=0ahUKEwjWiqv9w6vJAhUG1xoKHaVpDDwQFgg1MAU&amp;url=http%3A%2F%2Fpsychology.tools%2Fcross-sectional-formulation.html&amp;usg=AFQjCNH2qoQHbZAaK1bOOm7z6Ma6ZqwFoQ&amp;sig2=HUhpUrHcDqs8sUqg5wcQ4A" target="_blank">Hot Cross Bun"</a> or "maintenance cycle" formulation is called "Chaining" in DBT.<br /><br />Chaining is actually fairly straightforward and involves the following steps :-<br />Ask<br /><br /><ul><li>When did you first know that &nbsp;the problem behaviour would arise?</li><li>If you were in situation again what would you do differently?</li><li>What stopped you this time?</li><li>What made you vulnerable at this time</li></ul><br /><ul><li>What happened when you stopped</li><li>What are the consequences?</li><li>What can we learn from this?</li></ul><div></div><br /><div>Then ask them to describe the sequence as if telling an actor how to play the part. It needs to be spefific. You are finding out the chain of antecedants, behaviours and consequences in terms of thoughts, feelings, urges and behaviours.</div><div><br /></div><div>This article provides a <a href="https://contextualscience.org/files/Schmidt,%20Chain%20Analysis%20in%20DBT.pdf" target="_blank">really good detailed account of chaining</a></div></div><div><div></div></div><div></div><div><br /></div><h2><b>8) The Role of individual sessions</b></h2><div>A lot of the skills learning takes place in the group sessions, but individal sessions are important too. In these you make list of target unhelpful behaviours to reduce&nbsp;</div><div>In each session work through list in each area hierarchically</div><div>They bring in diary/ Your job is to keep them "on the hook"&nbsp;</div><div><br /></div><div><br /></div><div><br /></div><br /><div><div><h2><b>9) Wise Mind</b></h2></div></div>DBT makes the helpful distinction between Logical. Emotional &nbsp;and wise mind<br />Logic is great - but what it would be like to be just in logical mind, like Mr Spock?<br />We would lose a large part of what it is to be human, what motivates us and what makes us individual. &nbsp;Fear keeps us safe. Anger stops people treating us like a doormat<br /><div></div>Yet emotions can get us into a lot of trouble.<br /><br /><div>We need emotions - but in moderation<br /><br />Wise mind can moderate emotions, its the synthesis of logical mind and emotional mind.<br /><br /></div><div>Here is an exercise that might help you locate your own wise mind<br />Think of a dilemma</div><div>Start with facts and logic</div><div>Then think about the emotions and desires connected with the dilemma</div><div>Imagine falling &nbsp;down &nbsp;a well taking all the facts and feelings with you. At the bottom is<br />a trap door. Through this trap door is your wise mind, which takes into account logic and feelings. Go through the trap door? What does wise mind tell you is right for you?<br /><br />Here are useful <a href="http://www.getselfhelp.co.uk/docs/WiseMindWorksheet.pdf" target="_blank">worksheets</a> and&nbsp;&nbsp;<a href="http://www.dbtselfhelp.com/wise_mind.pdf" target="_blank">handouts</a> about wise mind</div><div><br /></div><br /><h2><br /><b>10) Use of Metaphors&nbsp;</b></h2><div>Wise Mind is one metaphor used in DBT - there are lots of others that are used in DBT<br /><br />For example<br /><br /><ul><li>Tigger and eeore</li><li>If you want a decent life you have to experience the pain</li><li>Change your home page&nbsp;</li><li>Thoughts can be like junk mail</li><li>Make a lemonade out of lemons.&nbsp;</li><li>Need to go through pain barrier to get through marathon</li></ul></div><div>Here is a link to other <a href="http://www.getselfhelp.co.uk/metaphors.htm" target="_blank">metaphors of use in therapy</a>&nbsp; a good <a href="https://www.google.co.uk/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=7&amp;cad=rja&amp;uact=8&amp;ved=0ahUKEwi7jcaHyavJAhVGfhoKHYXZBNEQFghPMAY&amp;url=http%3A%2F%2Fsamples.sainsburysebooks.co.uk%2F9780470060001_sample_379387.pdf&amp;usg=AFQjCNFIpKJZgS4crGqnDUlbGS3C6zzTwQ&amp;sig2=kIGTUBHETl8t6cX388tAAw" target="_blank">article</a> and a couple of really good books<br /><a href="https://www.google.co.uk/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=2&amp;cad=rja&amp;uact=8&amp;sqi=2&amp;ved=0ahUKEwiTqMSbyavJAhUDOhoKHQN2AuUQFggmMAE&amp;url=http%3A%2F%2Fwww.amazon.co.uk%2FOxford-Guide-Metaphors-CBT-Behavioural%2Fdp%2F0199207496&amp;usg=AFQjCNHAOoPUiv6w0Nbn5J7-LgRqhUXhzA&amp;sig2=EdKyxr6Ffq25VC10nFgq-w&amp;bvm=bv.108194040,d.d2s" target="_blank">Oxford Guide to Metaphors in CBT</a><br /><a href="https://books.google.co.uk/books/about/Stories_and_Analogies_in_Cognitive_Behav.html?id=wlYRzt64zZgC&amp;redir_esc=y" target="_blank">Stories and Analogies in CBT</a></div><div><br /></div><div><b>Further Resources</b><br /><b><br /></b><br />F<a href="http://www.bipolarsjuk.se/pdf/Handbook%20in%20DBT%20Group.pdf" target="_blank">ree 85 page DBT Skills Booklet</a><br />Really comprehensive site full of <a href="http://ilovedbt.com/dbt-handouts-worksheets/" target="_blank">free DBT resources</a><br /><h1 class="a-size-large a-spacing-none" id="title" style="background-color: white; box-sizing: border-box; color: #111111; font-family: Arial, sans-serif; font-size: 21px !important; line-height: 1.3 !important; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding: 0px; text-rendering: optimizeLegibility;"><span class="a-size-large" id="productTitle" style="box-sizing: border-box; font-size: 19px !important; line-height: 1.3 !important; text-rendering: optimizeLegibility;"><a href="http://www.amazon.co.uk/DBT%C2%AE-Skills-Training-Handouts-Worksheets/dp/1572307811/ref=sr_1_fkmr0_1?ie=UTF8&amp;qid=1448454545&amp;sr=8-1-fkmr0&amp;keywords=dbt+training+guide" target="_blank">DBT® Skills Training Handouts and Worksheets</a></span></h1><div><a href="http://www.amazon.co.uk/Dialectical-Behavior-Therapy-Skills-Workbook/dp/1572245131/ref=pd_sim_14_4?ie=UTF8&amp;dpID=51h8yCcWm0L&amp;dpSrc=sims&amp;preST=_AC_UL160_SR128%2C160_&amp;refRID=0AR7N1TBDYG95NJJQ7K8" target="_blank">DBT Therapy Skills Book</a></div><b><br /></b><b>There are also a number of Apps for clients to help develop DBT skills</b><br /><br /><div style="-webkit-text-stroke-width: 0px; color: black; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px;"><div style="margin: 0px;"><br /></div></div></div><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
Visit http://www.timlebon.com/consultations.htm
Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2015/11/10-things-i-learnt-from-fiona-kennedys.htmlnoreply@blogger.com (Tim LeBon)0tag:blogger.com,1999:blog-4642274826047849093.post-4883902721956987407Wed, 18 Mar 2015 12:00:00 +00002015-03-18T20:13:34.637+00:00guided discoveryhow to do CBTHow to do CBT (Part 3 of series)<br /><div class="MsoNormal"><br /><div>This is the third and final &nbsp;part of a series of articles about three ways of doing CBT with a hypothetical client, "John".&nbsp;</div><div><br /></div><div><blockquote class="tr_bq"><span style="font-family: Arial, Helvetica, sans-serif;">John comes to CBT because of his depression.&nbsp; He is a 40 year old who has recently been made redundant. He is worried about getting a job again and his redundancy has also&nbsp; caused tension in his marriage. When questioned about how he spends his time now, he says he gets up late, intends to look for jobs but ends up doing very little. He feels demotivated, discouraged and, at times, hopeless.&nbsp; He is having trouble sleeping and hints that he may be using drinking to cope with his difficulties.&nbsp; At times, he says, he wonders if he will ever get a job again.&nbsp; He sees his redundancy as meaning that he is a failure.&nbsp; He talks in&nbsp; a flat, slow monotone. As he talks, he is becoming more sad and more hopeless.</span></blockquote><br />In the first article, <a href="http://cbtfortherapists.blogspot.co.uk/2012/06/how-not-to-do-cbt-part-1.html" target="_blank">counsellor A </a>had a &nbsp;short car-crash session, in the second article <a href="http://cbtfortherapists.blogspot.co.uk/2012/06/how-not-to-do-cbt-part-1.html" target="_blank">counsellor B</a> &nbsp;if anything &nbsp;did even worse. &nbsp;Yet both included good evidence-based CBT ideas ... Now we will see how counsellor C takes a somewhat different approach so the session lasts a bit longer ...<br /><br /></div><b><u>How to do CBT: Counsellor C with John<o:p></o:p></u></b></div><div class="MsoNormal"><br /></div><div class="MsoNormal">C1: Good to see you again, John, &nbsp;I can see from the PHQ9 scores you filled in whilst you were waiting that it’s been quite a tough week but there’s been some improvement. Is that how it seems to you?<o:p></o:p></div><div class="MsoNormal">J1:&nbsp; I didn’t realise there had been improvement. Still feels pretty grim at times to be honest<o:p></o:p></div><div class="MsoNormal">C2: Sorry to hear that – shall we put that as one of the items on our agenda for today?<o:p></o:p></div><div class="MsoNormal">J2: OK<o:p></o:p></div><div class="MsoNormal">C3: What shall we put?<o:p></o:p></div><div class="MsoNormal">J3: “Feeling pretty grim at times?”<o:p></o:p></div><div class="MsoNormal">C4; OK … Just at times?<o:p></o:p></div><div class="MsoNormal">J4: Well, probably quite a lot of the time to be honest<o:p></o:p></div><div class="MsoNormal">C5: OK, I’ve written here under Agenda – “ 1. Addressing feeling grim a quite a lot of the time.”. OK?<o:p></o:p></div><div class="MsoNormal">J5: Yes<o:p></o:p></div><div class="MsoNormal">C6; Now we have an ongoing agenda item – review homework – so we’ll do that first as usual. I’d also like to add to the agenda –“pros and cons of being active” – is there anything else you would like to add?<o:p></o:p></div><div class="MsoNormal">J5: Well, to be honest I’ve been wondering whether I’m wasting your time.<o:p></o:p></div><div class="MsoNormal">C7: OK, that’s something we should definitely add to the agenda (writes down “Am I wasting counsellor’s time?”). &nbsp;We’ll look at that more fully later,&nbsp; but can you just say a little now about why you think you are wasting my time?<o:p></o:p></div><div class="MsoNormal">J6: I still haven’t got a job. I still waste most of my time.&nbsp; I’m a waste of space ….<o:p></o:p></div><div class="MsoNormal">C8: It sounds like that’s definitely an important thing for us to look at. We’ve got 4 things on our agenda – review homework, Address feeling grim, pros and cons of being active and am I wasting counsellor’s time. I’m wondering whether that might be a good order to look at things? I’m thinking that later in the session we might have a better idea about how useful this process is for you.<o:p></o:p></div><div class="MsoNormal">J7 : That makes sense.<o:p></o:p></div><div class="MsoNormal">C9: So, how did you get on with the&nbsp; homework?<o:p></o:p></div><div class="MsoNormal">J8: (Gets sheet out of pocket) Here it is.<o:p></o:p></div><div class="MsoNormal">C10: Would you like to talk me through it?<o:p></o:p></div><div class="MsoNormal">J9:OK …Well, on Wednesday I didn’t feel great, I didn’t really feel like going out &nbsp;but I had a letter to post so went into town and actually it looks like my mood did go up from a 4 to a 5. Then the rest of the day wasn’t so bad. Thursday was bad though. I woke up feeling totally lacking in energy.&nbsp;&nbsp; I stayed in bed .. didn’t get up until 200. Then it felt like it was too late to do anything. Then later in the evening I felt even worse, thinking “I’ve wasted the day, I’m never going to get better.”<o:p></o:p></div><div class="MsoNormal">C11: And what happened to your mood on Thursday?<o:p></o:p></div><div class="MsoNormal">J10: It started at 3 – then went down to a 2 in the evening. Not great.<o:p></o:p></div><div class="MsoNormal">C12: No, it doesn’t sound like a good day at all. Still, hat was a great effort to fill the forms in even though you were feeling so low. Well done. Shall we look at the two days together and see what we can learn from them?<o:p></o:p></div><div class="MsoNormal">J11: Sure<o:p></o:p></div><div class="MsoNormal">C12: So on Wednesday, you didn’t feel like going out, but do did and then you felt better. What can we learn from that?<o:p></o:p></div><div class="MsoNormal">J12: Maybe that being active helps, but that sometimes we don’t feel like being active.<o:p></o:p></div><div class="MsoNormal">C13: Exactly. So should we always do what we feel like doing?<o:p></o:p></div><div class="MsoNormal">J13: No, because actually&nbsp; I felt better after I did what I didn’t feel like doing<o:p></o:p></div><div class="MsoNormal">C14: That’s a very important insight you’ve captured there, John. We often do feel better when we are more active. But when depressed we don’t feel like being active. So what have we got to do to lift the depression?<o:p></o:p></div><div class="MsoNormal">J14: Be active even when we don’t feel like it?<o:p></o:p></div><div class="MsoNormal">C15: Exactly. How would you feel about trying that as part of the homework for next week?<o:p></o:p></div><div class="MsoNormal">J15: I’ll try. <o:p></o:p></div><div class="MsoNormal">C16: Let’s write it down. “Last weeks’ homework suggests that it will help to be active even when I don’t feel like it.” What else do we need to record? <o:p></o:p></div><div class="MsoNormal">J16: Maybe how I feel about being active at the time?<o:p></o:p></div><div class="MsoNormal">C17: Right, so let’s add another column to your record sheet – “How I feel about being active”. How does that sound? Can you imagine recording this?<o:p></o:p></div><div class="MsoNormal">J17: Yes<o:p></o:p></div><div class="MsoNormal">C18: Do you think it might be helpful?<o:p></o:p></div><div class="MsoNormal">J18: Yes<o:p></o:p></div><div class="MsoNormal">C19: OK – just to make certain, let’s see how that might have panned out on Thursday. If you’d been tracking your thoughts then as well, what would you have written down?<o:p></o:p></div><div class="MsoNormal">J19: Let me think. Probably “I’ve no energy so I’ll stay in bed?”<o:p></o:p></div><div class="MsoNormal">C20: Bearing in mind what we’ve just learnt, what do you think now?<o:p></o:p></div><div class="MsoNormal">J20: Even though I don’t feel like being active, if I do I’ll feel better<o:p></o:p></div><div class="MsoNormal">C21. Great. So I’m wondering if we need another column, like this (Adds another column –“more helpful thought.”) How does that look?<o:p></o:p></div><div class="MsoNormal">J21: Looks good – not sure though if it will work though if I am feeling as low as I did on Thursday.<o:p></o:p></div><div class="MsoNormal">C22: Is it worth trying?<o:p></o:p></div><div class="MsoNormal">J22: Yes, it’s worth a try.<o:p></o:p></div><div class="MsoNormal">J23: How are you feeling now about our work today so far?<o:p></o:p></div><div class="MsoNormal">J22: Good<o:p></o:p></div><div class="MsoNormal">C23: Me too.. Shall we take stock. So far today we’ve reviewed the homework, and seen that on the day when you are more active, you feel better. So we have set up a homework task next week where you notice negative thoughts telling you not to be active, and do your best at answering back to them and then being active – again recording how you feel afterwards. Have I missed anything?<o:p></o:p></div><div class="MsoNormal">J23: No<o:p></o:p></div><div class="MsoNormal">C24: So&nbsp; shall we move on to the other agenda items. We had &nbsp;“wasting my time” –do you still think you are wasting my time?<o:p></o:p></div><div class="MsoNormal">J24; No, not nearly so much<o:p></o:p></div><div class="MsoNormal">C25: Good, neither do I. Shall we move on to the next item on our agenda?<o:p></o:p></div><div class="MsoNormal">J25: Yes.<o:p></o:p></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><br /></div><div class="MsoNormal">What did counsellor C do differently?</div><div class="MsoNormal"><br /></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><br /></div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: -37.15pt; mso-border-alt: solid windowtext .5pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 1184; width: 699px;"><tbody></tbody></table><div class="MsoNormal"><br /></div><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
Visit http://www.timlebon.com/consultations.htm
Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2015/03/how-to-do-cbt-part-3-of-series.htmlnoreply@blogger.com (Tim LeBon)1tag:blogger.com,1999:blog-4642274826047849093.post-6736632967401677339Fri, 13 Mar 2015 09:57:00 +00002015-03-13T09:57:00.212+00:00CBT songsdepressionmusicsocialisationsongsAnother song for depression : Better get to livin' by Dolly Parton<div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="" class="YOUTUBE-iframe-video" data-thumbnail-src="https://ytimg.googleusercontent.com/vi/MKeulwZ3sGE/0.jpg" frameborder="0" height="266" src="http://www.youtube.com/embed/MKeulwZ3sGE?feature=player_embedded" width="320"></iframe></div><br /><br /><div class="la" style="background-color: white; border-top-width: 0px; font-family: Arial; font-size: 14.6666669845581px; padding: 0px 4px; width: 627.1875px;"><div class="lb" style="font-size: 9pt; font-style: italic; line-height: 18pt;">By: Dolly Parton &amp; Kent Wells</div></div><br style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;" /><span style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;">People always comin' up to me and askin'&nbsp;</span><br /><span style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;">"Dolly, what's your secret?&nbsp;</span><br /><span style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;">With all you do, your attitude&nbsp;</span><br /><span style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;">Just seems to be so good&nbsp;</span><br /><span style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;">How do you keep it?"&nbsp;</span><br /><span style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;">Well I'm not the Dalai Lama, but I'll try&nbsp;</span><br /><span style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;">To offer up a few words of advice</span><br /><span style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;"><br /></span><br /><div style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;"><i>Chorus:</i></div><div style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;">You better get to livin', givin'<br />Don't forget to throw in a little forgivin'<br />And lovin' on the way<br />You better get to knowin', showin'<br />A little bit more concerned about where you're goin'<br />Just a word unto the wise<br />You better get to livin'</div><div style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;"><br /></div><div style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;">A girlfriend came to my house<br />Started cryin' on my shoulder Sunday evening<br />She was spinnin' such a sad tale<br />I could not believe the yarn that she was weavin'<br />So negative the words she had to say<br />I said if I had a violin I'd play</div><div style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;"><br /></div><div style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;">I said you'd better get to livin', givin'<br />Be willing and forgivin'<br />Cause all healing has to start with you<br />You better stop whining, pining<br />Get your dreams in line<br />And then just shine, design, refine<br />Until they come true<br />And you better get to livin'</div><div style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;"><br /></div><div style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;">Your life's a wreck, your house is mess<br />And your wardrobe way outdated<br />All your plans just keep on falling through<br />Overweight and under paid, under appreciated<br />I'm no guru, but I'll tell you<br />This I know is true</div><div style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;"><br /></div><div style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;">You better get to livin', givin'<br />A little more thought about bein'<br />A little more willin' to make a better way<br />Don't sweat the small stuff<br />Keep your chin up<br />Just hang tough<br />And if it gets too rough<br />Fall on your knees and pray<br />And do that everyday<br />Then you'll get to livin'</div><div style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;"><br /></div><div style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;">The day we're born we start to die<br />Don't waste one minute of this life<br />Get to livin'<br />Share your dreams and share your laughter<br />Make some points for the great hereafter</div><div style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;">Better start carin'<br />Better start sharin'<br />Better start tryin'<br />Better start smiling<br />And you better get to livin'</div><div style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;"><br /></div><div style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;"><br /></div><div style="background-color: white; font-family: Arial; font-size: 14.6666669845581px;">Dolly Parton has spoken about her own <a href="http://www.express.co.uk/news/showbiz/471307/Dolly-Parton-discusses-depression-worries-ahead-of-Glastonbury-slot" target="_blank">history of depression&nbsp;</a>&nbsp; The "Better get to living" &nbsp;idea is non-pharmeceutical anti-depressant.</div><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
Visit http://www.timlebon.com/consultations.htm
Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2015/03/another-song-for-depression-better-get.htmlnoreply@blogger.com (Tim LeBon)2tag:blogger.com,1999:blog-4642274826047849093.post-1753480606243855194Thu, 12 Mar 2015 09:47:00 +00002015-03-12T09:47:20.703+00:00guided discoveryhumoursocrating questioningHow not to do guided discovery<br /><br /><a href="http://www.bbc.co.uk/programmes/b01l1dl0">http://www.bbc.co.uk/programmes/b01l1dl0</a><br /><br />From 17 min 30 secs - lasts about 4 minutes<br /><br />This link will very likely expire in which case check out <b>&nbsp;John Finnemore's Souvenir Programme</b><br /><b>Series 2 Episode 1</b><br /><br /><h1 class="no-margin" property="name" style="background-color: #003366; color: white; font-family: Arial, Helvetica, freesans, sans-serif; font-size: 2rem; letter-spacing: -0.03em; line-height: 1.125; margin: 0px;">Episode 1</h1><div class="gamma" style="background-color: #003366; color: white; font-family: Arial, Helvetica, freesans, sans-serif; font-size: 1.25rem; letter-spacing: -0.03em; line-height: 1.2; margin-bottom: 0.6em;"><span class="context__item" style="border: 0px; clip: rect(0px 0px 0px 0px); height: 1px; overflow: hidden; padding: 0px; position: absolute; width: 1px;"><span property="partOfSeries" resource="http://www.bbc.co.uk/programmes/b01mk97n" typeof="Series"><a content="http://www.bbc.co.uk/programmes/b01mk97n" href="http://www.bbc.co.uk/programmes/b01mk97n" property="url" style="color: #fcd164; font-weight: bold; text-decoration: none;">John Finnemore's Souvenir Programme</a></span>,</span><span class="context__item"><span property="partOfSeason" resource="http://www.bbc.co.uk/programmes/b01mk989" typeof="Season"><a content="http://www.bbc.co.uk/programmes/b01mk989" href="http://www.bbc.co.uk/programmes/b01mk989" property="url" style="color: #fcd164; font-weight: bold; text-decoration: none;">Series 2</a></span></span>&nbsp;<span style="font-size: 14px; line-height: 16.3636360168457px;">&nbsp;John Finnemore, the writer and star of Cabin Pressure, regular guest on The Now Show and popper-upper in things like Miranda and Family Guy, records a second series of his hit sketch show.</span></div><div style="background-color: #003366; color: white; font-family: Arial, Helvetica, freesans, sans-serif; font-size: 14px; line-height: 16.3636360168457px; margin-bottom: 1.28571429em;">The first series was<span class="ml__ellipsis">&nbsp;described as "sparklingly clever" by The Daily Telegraph and "one of the most consistently funny sketch shows for quite some time" by The Guardian. It featured Winnie the Pooh coming to terms with his abusive relationship with honey, how The Archers sounds to people who don't listen to the Archers and how Dr Jekyll and Mr Hyde decided whose turn it was to do the washing up.</span></div><div class="ml__hidden" style="background-color: #003366; color: white; font-family: Arial, Helvetica, freesans, sans-serif; font-size: 14px; line-height: 16.3636360168457px; margin-bottom: 1.28571429em;">This episode doesn't feature any of those things, but it does feature an awkward celestial relationship, surprisingly easy contract negotiations, and a trailer for a film about the only mode of transport that hasn't had a film made about it yet.</div><div class="gamma" style="background-color: #003366; color: white; font-family: Arial, Helvetica, freesans, sans-serif; font-size: 1.25rem; letter-spacing: -0.03em; line-height: 1.2; margin-bottom: 0.6em;"><span class="inset" style="padding-left: 16px; padding-right: 16px;"><span property="episodeNumber"><span style="font-size: 14px; line-height: 16.3636360168457px;">John Finnemore's Souvenir Programme is written by and stars John Finnemore. It also features Margaret Cabourn-Smith, Simon Kane, Lawry Lewin and Carrie Quinlan. It is produced by Ed Morrish.</span>1</span>&nbsp;of&nbsp;<span property="numberOfEpisodes">6</span></span></div><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
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http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2015/03/how-not-to-do-guided-discovery.htmlnoreply@blogger.com (Tim LeBon)0tag:blogger.com,1999:blog-4642274826047849093.post-918867330925556372Mon, 02 Mar 2015 12:48:00 +00002015-03-02T12:48:00.374+00:00CBT songshumoursocialisationWhat songs are helpful in CBT?<br />To get away from an over-clinical, unfriendly caricature that CBT is sometimes associated with, it can be helpful to make CBT more human. One way of doing this is to mention songs that reflect CBT principles or ideas. Here are a few I have used<br /><br />1. <a href="http://en.wikipedia.org/wiki/Both_Sides,_Now" target="_blank">Both Sides Now </a>(Joni Mitchell)<br /><br /><div class="separator" style="clear: both; text-align: center;"><iframe width="320" height="266" class="YOUTUBE-iframe-video" data-thumbnail-src="https://ytimg.googleusercontent.com/vi/XRjsS3sgY5I/0.jpg" src="http://www.youtube.com/embed/XRjsS3sgY5I?feature=player_embedded" frameborder="0" allowfullscreen></iframe></div><br /><br /><br />An great old song, some younger folks may be familiar with it from <a href="https://www.youtube.com/watch?v=2y-8vxObugM" target="_blank">Love Actually.</a><br /><br /><br />The message here is - there is more than one way of looking at things &nbsp;- the negative one isnt necessarily the only one. Perhaps I can look at this another way.<br /><br />2. <a href="https://www.youtube.com/watch?v=J_frDwckrys" target="_blank">Paint it, Black</a> - The Rolling Stones<br /><br /><div class="separator" style="clear: both; text-align: center;"><iframe width="320" height="266" class="YOUTUBE-iframe-video" data-thumbnail-src="https://ytimg.googleusercontent.com/vi/n1zBG2TEjn4/0.jpg" src="http://www.youtube.com/embed/n1zBG2TEjn4?feature=player_embedded" frameborder="0" allowfullscreen></iframe></div><br /><br />Another old classic - illustrates "how you feel affects how you think" principle. When we are depressed, we paint everything black. This song can help the client feel understood - and perhaps provide some distancing from this unhelpful strategy<br /><br />3. <a href="http://en.wikipedia.org/wiki/Hold_Your_Head_Up" target="_blank">Hold Your Head Up</a> &nbsp;Argent<br /><div><br /></div><br /><div class="separator" style="clear: both; text-align: center;"><iframe width="320" height="266" class="YOUTUBE-iframe-video" data-thumbnail-src="https://ytimg.googleusercontent.com/vi/yBVOHAkRdZ0/0.jpg" src="http://www.youtube.com/embed/yBVOHAkRdZ0?feature=player_embedded" frameborder="0" allowfullscreen></iframe></div><br /><br />I've mentioned this song to clients with social anxiety - don't care what other people think, hold yuor head up. One client turned it into a helpful mantra.<br /><br />4. Fans of The Sopronos might remember with affection Tony's lamenting that he wish he was more like the Happy Wanderer of the song. &nbsp;There's plenty of evidence that exercise can help overcome low mood, and this song coud link with behavioural activation in general.<br /><br /><div class="separator" style="clear: both; text-align: center;"><iframe width="320" height="266" class="YOUTUBE-iframe-video" data-thumbnail-src="https://ytimg.googleusercontent.com/vi/iQRzTtkIP64/0.jpg" src="http://www.youtube.com/embed/iQRzTtkIP64?feature=player_embedded" frameborder="0" allowfullscreen></iframe></div><br /><br />5. Here's one that you won't find in the charts - &nbsp;Windy Dryden's classic renditioning of Moves Like <strike>Jagger</strike>&nbsp;Dryen<br /><div class="separator" style="clear: both; text-align: center;"><iframe width="320" height="266" class="YOUTUBE-iframe-video" data-thumbnail-src="https://ytimg.googleusercontent.com/vi/J_frDwckrys/0.jpg" src="http://www.youtube.com/embed/J_frDwckrys?feature=player_embedded" frameborder="0" allowfullscreen></iframe></div><br /><br />I've previously posted a <a href="http://blog.timlebon.com/2014/12/10-happy-and-positive-songs-for-xmas.html" target="_blank">playlist of happy songs</a> that might also be helpful!<br /><br />Finally, here's a <a href="http://www.cbttherapies.org.uk/2011/04/08/feel-good-music/" target="_blank">competition </a>to turn unhelpful song lyrics into helpful lyrics - give it a go!<br /><br /><br />What songs would you add to these as helpful or relevant for CBT?<br /><br /><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
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http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2015/03/what-songs-are-helpful-in-cbt.htmlnoreply@blogger.com (Tim LeBon)3tag:blogger.com,1999:blog-4642274826047849093.post-25314609263838946Sun, 01 Mar 2015 10:51:00 +00002015-03-01T10:51:40.724+00:00cognitive principlediffusiondressillusionssocialisationthoughts are not factsHow to use that dress to socialise clients into CBT<div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-YiwZM0xNCyU/VPLqE_iu54I/AAAAAAAAwwM/eUSj03cj75w/s1600/-True_colors_The_dress_made_by_the_company_Roman_Originals_is_in_-a-7_1425040500135.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/-YiwZM0xNCyU/VPLqE_iu54I/AAAAAAAAwwM/eUSj03cj75w/s1600/-True_colors_The_dress_made_by_the_company_Roman_Originals_is_in_-a-7_1425040500135.jpg" height="320" width="245" /></a></div><br />You've probably seen the debate about "<a href="http://www.wired.com/2015/02/science-one-agrees-color-dress/" target="_blank">The Dress" </a>on social media and the intenet.<br />What colour do you see the dress above as now?<br />Is it black and blue? Is it white and gold? Perhaps, like me, one time you see it one colour, and then when you return to it it looks different.<br /><br />So - What has the dress got to do with CBT ...<br /><br /><br />Along with <a href="http://www.ibtimes.co.uk/thedress-rubins-vase-young-lady-old-lady-other-famous-optical-illusions-1489764" target="_blank">other optical illusions</a>, like "Is it duck or rabbit?"<br /><br /><br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-iC1mRF7f-Oo/VPLrXpKARHI/AAAAAAAAwwY/f1faaJBcS9M/s1600/duck-rabbit.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-iC1mRF7f-Oo/VPLrXpKARHI/AAAAAAAAwwY/f1faaJBcS9M/s1600/duck-rabbit.jpg" height="215" width="320" /></a></div><br /><br />these help create doubt about us being so certain that how we see things is necessarily how they really are. Thoughts are not facts. That's a useful idea to convey to the client in CBT. &nbsp; For example:-<br /><br />"At the moment you think the future is hopeless"<br />"You feel that you need to check those switches"<br />"You believe that when your boss asked for a meeting it means you are in trouble2<br /><br />Each of these ideas are interpretations, and in CBT the client learns that they are not facts. They &nbsp;may not be either the most accurate way of looking things or the most helpful.Optical illusions are a nice way of making the point; how we see things isn't necessarily how they really are.<br /><br />The interesting thing about the dress, more so than the duck rabbit, is that when we see it as black and gold, its actually hard to see it as white and gold - and vice-versa. &nbsp;This is often true when people are very &nbsp;depressed, ramped up through OCD. The message here is<br /><br /><blockquote class="tr_bq">At the moment you see things one way and it may wekk be &nbsp;hard to see it another way. As with that dress that you may have seen on the internet, could it be that there is another way of looking at your negative thoughts.&nbsp;</blockquote><br />If the client answers "yes" you can then add - so what does that mean about how you should treat some of your negative or unhelpful thoughts? &nbsp;If they answer "It means that I should treat them with some caution, as if they are just thoughts rather than the facts they claim to be" &nbsp;then you have &nbsp;socialised your client into an important CBT principle<br /><br /><br /><br /><br /><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
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http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2015/03/how-to-use-that-dress-to-socialise.htmlnoreply@blogger.com (Tim LeBon)1tag:blogger.com,1999:blog-4642274826047849093.post-4199885750566076722Sun, 20 Apr 2014 17:13:00 +00002014-04-20T18:13:33.434+01:00cts-rpassing cts-rtipsHow to Pass your CTSR<br />For CBT therapists, the<a href="https://drive.google.com/file/d/0B2Aw-nfxPPVMSjhUYU9OVk9EM1U/edit?usp=sharing" target="_blank"> CTS-R</a>&nbsp;(Cognitive Therapy Scale - Revised) is akin to a driving test. You tape a therapy session and your every intervention is assessed against twelve criteria. To pass, you (in my experience) need to get at least 2 out of 5 on each of the 12 scales and a minimum average overall rating of 3.<br /><br />The authors have provided a detailed<a href="https://drive.google.com/file/d/0B2Aw-nfxPPVMUjhYdGMwOEJFbms/edit?usp=sharing" target="_blank"> CTS-R Manual</a>&nbsp;which is well worth reading as it provides a detailed rationale and guidance. However, the manual is 30 pages long, so I have found its useful to have a one page summary - or crib - to read just before you go in for your "CBT driving test".<br /><br />So here is my personalised <a href="https://www.dropbox.com/s/634827hdrg5xn42/CTSR%20-2014%20Crib.doc" target="_blank">CTS-R 1 page summary</a><br /><br />I hope it proves useful. If you have some more tips, feel free to add them to the comments.<br />I'm also including some extra tips below, because, as with your driving test, doing your CTS-R can be quite a nerve-racking experience and you need all the help you can get<br /><br /><b>1) Choose your clients for CTS-R recordings carefully</b><br />Just as you wouldnt want to do your driving test going through Spaghetti Junction at rush hour, you wouldnt want to record a CTS-R session with a client with bipolar disorder or noticeable personality disorder. Of course you might want to record sessions with such a client and ask for feedback - but they are not the right clients to use when you are in training and trying to pass your CTS-R.<br /><br /><b>2) Pick the right stage of therapy</b><br />You wouldn't pass the CTS-R in an assessment session at the very beginning or in the last review session, and in general sessions at the beginning and end of therapy are not ideal. If you are doing short-term CBT, probably sessions 3-8 would be about right.<br /><br /><b>3) Practise before you submit a recording - and listen to it</b><br />I you want the pass on all items, you had better start getting into the habit of agenda setting, summarising regularly etc. Then listen to your recordings and mark yourself, and see what you need to improve on<br /><b><br /></b><b>4) Help your assessor understand your interventions</b><br />By this I don't mean reacting defensively when the assessor misses your brilliant piece of guided discovery or formulation. Much better instead to do one of the following<br />* Include with your tape a written explanation, minute by minute of your interventions. e.g. 10-20 mins - guided discovery regarding how to overcome fears<br />* Include with your tape details of the client including formulation and summary of treatment plan, therapist goals etc<br />* If possible, use a client which the assessor is familiar with e.g. you might have brought to supervision last time. If so, make sure you have considered implementing ideas brought up in supervision<br />* In the session itself, signpost what you are doing. For example, use phrases such as "to summarise" or "now that we have set an agenda". Your assessor is only human!<br /><br />Those are my top tips -but what do you think?<br />Good luck, and dont forget to help others with your own ideas in the comments.<div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
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http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2014/04/how-to-pass-your-ctsr.htmlnoreply@blogger.com (Tim LeBon)2tag:blogger.com,1999:blog-4642274826047849093.post-3716207183466786513Wed, 12 Jun 2013 12:11:00 +00002013-06-12T13:11:41.997+01:00CBTengagementsimilessocialisationHow to engage and socialise clients into CBT more quickly<div>The other day &nbsp;I had an unbalanced yet illuminating psychotherapy day. Of the 5 clients I saw, 4 were just starting therapy, either having an assessment or in their early sessions, and the other was at session 12, near the end of her therapy journey.</div><div><br /></div><div>For the client nearing the end of therapy , the session almost ran itself. We quickly settled on an agenda, reviewed home practice and then the client herself was able to apply the formulation and new ways of thinking and behaving to her issues. It felt like real teamwork, and we both left the session &nbsp;feeling &nbsp;really good about it. I felt full of energy and enthusiasm</div><div><br /></div><div>With the other clients &nbsp;it was a different story. I was spending a lot of time and energy keeping the structure of the session tight, dealing with any doubts the client had about CBT &nbsp;and trying to match what they were saying and what they wanted with how &nbsp;CBT understands things and what it can offer. I do not know how these clients felt about the sessions, but I felt drained and wishing I could &nbsp;have done a better job.</div><div><br /></div><div>The contrast could not have been greater. Yet that the first client had been just like the other clients a few months ago. She and I had climbed the CBT mountain and now it was all &nbsp;downhill, in a good way.</div><div><br /></div><div>My question is this. How can we CBT therapists get to the top of the CBT mountain more quickly? How can we get to that wonderful feeling of teamwork, collaboration and fruitful work being done in 3 sessions rather than 5? How can we have less clients needlessly dropping out of treatment?</div><div><br /></div><div>Here are some thoughts</div><div><br /></div><div><ul><li>Explain to the client that the first sessions aren't so much about curing the problem as understanding it-this sets the scene for formulation work.&nbsp;</li><li>Use disorder-specific models when you can - they provide a compass for you to follow</li><li>Use metaphors, similes and stories as part of the psycheducation. For example if dealing with OCD, you may ask the client to think of OCD as being like a school bully that keeps asking for more</li><li>Give appropriate reading as part of psychoeducation - my experience here is that less is more, and a sheet has much more chance of being read and digested than a book.</li><li>Ask the client to be actively involved in psychoeducation. "Which parts of the article apply to you?" "What are you unsure about?" are good questions.</li><li>Use guided discovery to convey the CBT model and aspects of it</li><li>Look for examples in the client's story that fits with CBT and draw their attention to it</li><li>Summarise &nbsp;more frequently than in later sessions , and ask the client to summarise back</li><li>Ask the client at the end and beginning of session what was most important thing from the session (or previous session)</li><li>Be structured right from the start and explain why CBT is structured. This gives you permission to politely interrupt the client if necessary</li><li>Set home practice right from the start of therapy and explain its vital importance</li><li>Ask the client to set their therapy goals early on in therapy and to grade where they are on them and keep coming back to them</li></ul></div><div><br /></div><div>What else do you think is important in the early sessions of therapy to help to get to the top of the CBT mountain more quickly?</div><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
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Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2013/06/how-to-engage-and-socialise-clients.htmlnoreply@blogger.com (Tim LeBon)4tag:blogger.com,1999:blog-4642274826047849093.post-6604852753836479297Mon, 08 Apr 2013 07:57:00 +00002013-04-08T08:57:43.117+01:00Evidence that regular meditation helps those with bipolar disorderPositive evidence that meditation (MBCT) can help bi-polar depression sufferers<br><div><span style="text-align:justify;word-spacing:-0.15ex;background-color:rgb(249,251,252);color:rgb(46,46,46);font-family:&#39;Arial Unicode MS&#39;,&#39;Arial Unicode&#39;,Arial,&#39;URW Gothic L&#39;,Helvetica,Tahoma,sans-serif;font-size:13px;line-height:20px">Those who meditated 3 days ro more per week during 8 week MBCT trrial had less anxiety and depression after treatment. The more they meditatin, the less depression -included</span></div> <div><span style="text-align:justify;word-spacing:-0.15ex;background-color:rgb(249,251,252);color:rgb(46,46,46);font-family:&#39;Arial Unicode MS&#39;,&#39;Arial Unicode&#39;,Arial,&#39;URW Gothic L&#39;,Helvetica,Tahoma,sans-serif;font-size:13px;line-height:20px">12 month follow-up</span></div> <div>See <a href="http://www.sciencedirect.com/science/article/pii/S0005796713000545">http://www.sciencedirect.com/science/article/pii/S0005796713000545</a></div> <div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
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http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2013/04/evidence-that-regular-meditation-helps.htmlnoreply@blogger.com (Tim LeBon)0tag:blogger.com,1999:blog-4642274826047849093.post-7797941521238321870Wed, 27 Mar 2013 21:09:00 +00002013-06-23T16:31:18.380+01:00cftcompassioncompassion focussed therapyfree downloadsmediation downloadsmeditationmindfulnesspaul gilbertpoisoned parrotself-attackCompassionate Mind Resources Page<br /><div class="MsoNormal"><br /></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><b>Free downloads<o:p></o:p></b></div><div class="MsoNormal"><a href="http://mindfulcompassion.com/Mindful_Compassion_in_New_York/CFT_Practice_Podcast/CFT_Practice_Podcast.html">http://mindfulcompassion.com/Mindful_Compassion_in_New_York/CFT_Practice_Podcast/CFT_Practice_Podcast.html</a><o:p></o:p></div><div class="MsoNormal"><a href="http://cct.gmu.edu/resources/well-being-practices/meditation-practices">http://cct.gmu.edu/resources/well-being-practices/meditation-practices</a><o:p></o:p></div><div class="MsoNormal"><a href="http://www.mindfulcompassion.com/cms/?cat=4">http://www.mindfulcompassion.com/cms/?cat=4</a><o:p></o:p></div><div class="MsoNormal"><a href="http://www.mindfulselfcompassion.org/meditations_downloads.php">http://www.mindfulselfcompassion.org/meditations_downloads.php</a><o:p></o:p><br /><a href="http://positivityresonance.com/meditations.html">http://positivityresonance.com/meditations.html</a></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><b>Information Sheets<o:p></o:p></b></div><div class="MsoNormal">Poisoned Parrot&nbsp; <a href="http://www.getselfhelp.co.uk/parrot.htm">http://www.getselfhelp.co.uk/parrot.htm</a><o:p></o:p></div><div class="MsoNormal"><a href="http://www.compassionatemind.co.uk/resources/Developing+qualities+of+Inner+Compassion+$28Client+Handout$29$281$29.pdf">http://www.compassionatemind.co.uk/resources/Developing+qualities+of+Inner+Compassion+$28Client+Handout$29$281$29.pdf</a><o:p></o:p></div><div class="MsoNormal"><a href="http://www.psychologytools.org/compassion-focused-therapy.html">http://www.psychologytools.org/compassion-focused-therapy.html</a><o:p></o:p></div><div class="MsoNormal"><a href="http://www.goodmedicine.org.uk/stressedtozest/2009/06/handouts-questionnaires-compassion-criticism-first-post">http://www.goodmedicine.org.uk/stressedtozest/2009/06/handouts-questionnaires-compassion-criticism-first-post</a><o:p></o:p></div><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
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Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2013/03/compassionate-mind-resources-page.htmlnoreply@blogger.com (Tim LeBon)0tag:blogger.com,1999:blog-4642274826047849093.post-6192272847220002251Thu, 21 Mar 2013 17:09:00 +00002013-03-21T17:09:56.040+00:00CBTcftchris ironscompassioncompassion focussed therapyloving kindnessmeditationmindfulnesspaul gilbertpersonality disordersthird-wave CBT10 Things I learnt from Compassion Focussed Therapy (CFT) Workshop with Chris Irons<br />I recently attended <a href="http://www.youtube.com/watch?v=9ULYf-gxAL8" target="_blank">Chris Irons</a>' one-day workshop on Compassion-Focussed Therapy (CFT). I was interested in learning about yet another t<a href="http://www.psychology.uiowa.edu/classes/31013sc1/Lecture%252012%2520Third-Wave%2520Behavioral%2520Therapies.ppt" target="_blank">hird wave CBT therapy</a>&nbsp;and also wanted to find out the answer to a number of questions, such as<br /><br /><ul><li>What is compassion?</li><li>Can compassion-based therapy help with shame and self-criticism?</li><li>How different is this approach from standard CBT?</li><li>What sort of client can CFT most help?</li></ul><div>Here are 10 things I learnt about CFT.</div><br /><br />1. <a href="http://compassionatemind.co.uk/" target="_blank">Compassion Focused Therapy</a>&nbsp; (CFT) is an evidence-based, integrative &nbsp;third-wave cognitive behavioural therapy particularly useful for people who experience high levels of<a href="http://en.wikipedia.org/wiki/Shame" target="_blank"> shame</a>, are highly self-critical and have previously lacked sufficient positive nurturing experiences.<br /><br />2. <a href="http://apt.rcpsych.org/content/15/3/199.full" target="_blank">Paul Gilbert,</a> the founder of CFT, is influenced not just by CBT but also by <a href="http://www.pseve.org/journal/UPLOAD/Gilbert6c.pdf" target="_blank">attachment theory</a>, neuroscience, Jung and social and developmental psychology. &nbsp;Whilst &nbsp;CBT is very &nbsp;helpful for many people, &nbsp;Gilbert found that some self-critical clients really struggled with CBT. They could relate to alternative perspectives t i<i>ntellectually </i>but struggled to really believe more positive ideas about themselves with their <i>heart</i>. &nbsp;This &nbsp;"head heart lag" occured most when clients had no experiences of nurturing to draw on. They couldn't feel positive about themselves, because they had no experience of feeling positive about themselves to draw on. &nbsp;This led Gilbert &nbsp;to &nbsp;<a href="http://www.thepsychologist.org.uk/archive/archive_home.cfm?volumeID=22&amp;editionID=175&amp;ArticleID=1505" target="_blank">move beyond CBT</a>&nbsp;and develop CFT.<br /><br /><span style="color: #222222; font-family: arial, sans-serif; font-size: x-small;">3. </span><span style="color: #222222; font-family: Arial, Helvetica, sans-serif;">From neuroscience, CFT takes the ideas of the <a href="http://en.wikipedia.org/wiki/Triune_brain" target="_blank">old brain and new brain</a> and&nbsp;<a href="http://books.google.co.uk/books?id=krNPL6xCVL0C&amp;pg=PA22&amp;lpg=PA22&amp;dq=three+major+emotion+regulation+systems.&amp;source=bl&amp;ots=odOYhRe4Vc&amp;sig=Nu2xKtYPwXvXLgWoOjSWMZ9LIv8&amp;hl=en&amp;sa=X&amp;ei=K5pFUYKJIsjUPNSUgLgO&amp;ved=0CDUQ6AEwAA#v=onepage&amp;q=three%20major%20emotion%20regulation%20systems.&amp;f=false" target="_blank">three major &nbsp;emotion regulation systems.</a></span><br /><br />The "old brain" is the fast automatic systems that occur in other animals, the "new brain" is the slower neocortex which more developed in humans and gives us our power to imagine, reason and plan and use language.<br /><span style="color: #222222; font-family: arial, sans-serif;">The <b>three emotion regulation systems</b> are particularly important in CFT and arecolour-coded in CFT to help clients remember them.</span><br /><br /><span style="background-color: white; color: red; font-family: arial, sans-serif;">Th</span><span style="background-color: white; color: red; font-family: arial, sans-serif;">reat &nbsp;and Protection &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;(RED)</span><br /><span style="background-color: white; color: blue; font-family: arial, sans-serif;">Achievement and Pleasure &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; (BLUE)</span><br /><span style="background-color: white; color: #38761d; font-family: arial, sans-serif;">Contentment, Soothing and Connection &nbsp; (GREEN)</span><br /><br /><span style="background-color: white; color: #cc0000; font-family: arial, sans-serif;"><u><b>The RED system. THREAT and PROTECTION. &nbsp; &nbsp; NEGATIVE EMOTIONS</b></u></span><br /><span style="background-color: white; color: #cc0000; font-family: arial, sans-serif;"><u><b><br /></b></u></span><span style="background-color: white; color: #cc0000; font-family: arial, sans-serif;">The world <i>is </i>a dangerous place, So it's good we have a part of our brain &nbsp;dedicated to protecting us.</span><span style="background-color: white; color: #cc0000; font-family: arial, sans-serif;">When threatened, a stress response will kick off the "old brain" and &nbsp;we will feel a strong urge to get away. The new brain is also part of the RED threat system - it worries and ruminates to try to help us deal with &nbsp;threats.</span><br /><span style="background-color: white; color: #cc0000; font-family: arial, sans-serif;">The Red Threat System is not a bad thing. You wouldn't want to be without it, &nbsp;But you can have too much of a good thing. The question to ask is - is your threat system sometimes in overdrive? Would it be helpful to develop your own switch which could turn the threat system down a notch or two sometimes? &nbsp;For those who are strongly self-critical and experience high levels of shame as well as those who experience other psychological problems, the answer may well be "YES".</span><br /><span style="background-color: white; color: blue; font-family: arial, sans-serif;"><br /></span><span style="background-color: white; color: blue; font-family: arial, sans-serif;"><b><u>The BLUE system. ACHIEVEMENT and PLEASURE. &nbsp;UNQUIET POSITIVE EMOTIONS</u></b></span><br /><span style="background-color: white; color: blue; font-family: arial, sans-serif;"><br /></span><span style="background-color: white; color: blue; font-family: arial, sans-serif;">Our body requires food, our species needs us to have sex in order to continue, society need us to achieve certain things in order for it to flourish. It makes sense that our brain motivates us to seek pleasure and achievement and rewards us when we do so. When we get depressed a lot of people have too little achievement and pleasure in their life. CBT and&nbsp;<a href="http://apt.rcpsych.org/content/14/1/29.abstract" target="_blank">Behavioural Activation</a>&nbsp;can help depressed people redress the balance. With other people, though, the blue system can become a problem. An addict may be too focussed on pleasure, the perfectionist on achievement. &nbsp;Self-esteem that is contingent on achievement can be as problem. If "You only sing when you're winning" is a problem in a world when not everyone can be winners. So as with the RED system, the BLUE system is both necessary and potentially dangerous.</span><br /><br /><span style="background-color: white; color: #38761d; font-family: arial, sans-serif;"><b><u>The GREEN system &nbsp;SAFENESS and SERENITY. &nbsp;CALM POSITIVE EMOTIONS</u></b></span><br /><span style="background-color: white; color: #38761d; font-family: arial, sans-serif;"><br /></span><span style="background-color: white; color: #38761d; font-family: arial, sans-serif;">As well as "unquiet" positive emotions such as excitement and adventure we can also have positive emotions associated with safety, contentment, serenity and peace.</span><br /><span style="color: #38761d; font-family: arial, sans-serif;">These &nbsp;calm positive emotions are linked to attachment and caring. Clients &nbsp;who have lacked secure attachment in childhood and have had insufficient emotional nourishment &nbsp;may have a deficit in this system. CFT aims to make the green &nbsp;system more powerful.</span><br /><span style="color: #38761d; font-family: arial, sans-serif;"><br /></span><span style="font-family: arial, sans-serif;">A CFT &nbsp;therapist will explain these three systems to clients and ask this key question</span><br /><blockquote class="tr_bq"><span style="font-family: arial, sans-serif;">&nbsp;If &nbsp;we were to draw your three systems as circles, what would be their relative size?&nbsp;</span>&nbsp;</blockquote>&nbsp;<span style="font-family: arial, sans-serif;">For many self-critical clients who experience large amounts of shame, the green system would be very small and the read system very large.</span><br /><span style="font-family: arial, sans-serif;"><br /></span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">4.&nbsp;Shame is different from and more problematic than either guilt or embarrassment.</span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;"><br /></span><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">Guilt occurs when you think you &nbsp;done something wrong and feel you need to make amends,. Guilt is linked to caring mentality and can be a good thing</span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;"><br /></span><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">Embarrassment occurs when you feel other people will judge what you have done adversely,&nbsp;</span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">but the incident doesn't sum you up - you may have walked home with your flies undone, but that doesn't say much about you as a person. It is something you i can tell other people about.</span><br /><span style="color: #222222; font-family: arial, sans-serif;"><br /></span><span style="color: #222222; font-family: arial, sans-serif;">Shame on the other hand is when you think that others will judge you adversely, and their judgement does encapsulate you as a person. You find it very difficult to tell other people about shameful episodes.&nbsp;</span><br /><span style="color: #222222; font-family: arial, sans-serif;">Shame is therefore a more tricky emotion and is more closely linked with hopelessness, suicide and less successful therapy outcomes. So if CFT can help people with high levels of shame, it will make an important contribution.</span><br /><span style="color: #222222; font-family: arial, sans-serif;">Shame is often divided into e</span><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">xternal shame - shame in other's eyes - and&nbsp;</span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">internal shame - feeling ashamed of ourselves,</span><br /><br /><div><span style="background-color: white; color: #222222; font-family: arial, sans-serif;"><br /></span></div><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">5. A simple idea that can help empower the green system and hence reduce self-criticism and shame is</span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;"><br /></span><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;<span style="font-size: large;"> <a href="http://www.youtube.com/watch?v=UYa6gbDcx18" target="_blank">It is not your fault</a></span></span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;"><br /></span><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">Evolution has left us with a flawed system. The old brain and new brain do not always interact well. The three emotional regulation systems aren't always in balance. You didn't choose your genes. You didn't choose which family you were born into. You didn't choose whether the </span><span style="color: #6aa84f;"><span style="background-color: white; font-family: arial, sans-serif;">green</span><span style="background-color: white; font-family: arial, sans-serif;">&nbsp;calming system</span></span><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">&nbsp; developed during childhood. I<b>t's not your fault</b></span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;"><br /></span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">6. CFT helps clients to develop both <a href="http://en.wikipedia.org/wiki/Mindfulness_(psychology)" target="_blank">mindfulness</a> and <a href="http://en.wikipedia.org/wiki/Compassion" target="_blank">compassion</a>.</span><br /><span style="color: #222222; font-family: arial, sans-serif;">CFT uses a range of therapeutic techniques familiar to the CBT therapist including psychoeducation, formulation, listening, behavioural experiments, exposure, agenda setting and home practice. Two skills that are &nbsp;particularly prominent in CFT are mindfulness meditation and compassion meditation.</span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">Mindfulness and compassion are different skills using different parts of the brain.</span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">The mindful brain is a new brain capacity . It increases one's&nbsp;</span><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">capacity to shift attention and awareness. and purposefully focus. You can have mindfulness without &nbsp;compassion - think of a &nbsp;sniper.</span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">Compassion on the other hand is an old brain capacity. You can have compassion without mindfulness -think of a parent running into a &nbsp;house on fire to &nbsp;save &nbsp;their child.&nbsp;</span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">CFT targets both.</span><br /><br /><div><span style="background-color: white;">7.</span><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">Compassion can be a powerful antidote to shame.&nbsp;</span><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">You can help clients develop compassion through imagery and meditation. &nbsp;This<a href="http://mindfulcompassion.com/Mindful_Compassion_in_New_York/CFT_Practice_Podcast/CFT_Practice_Podcast.html" target="_blank"> podcast</a> provides an example of compassion meditation.</span></div><br /><div></div><span style="background-color: white; color: #222222; font-family: arial, sans-serif;"><span style="background-color: white; color: #222222; font-family: arial, sans-serif;"><br /></span>8 Often clients will not like compassion at first. You need to expect resistance - this is part of the work. These people are uncomfortable with compassion, they aren't used to it, it may stir up difficult memories- you have to work with this. It's like working with a phobic -you don't give up just because they don't want to be exposed to their fear.</span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">Clients may have a lot of metacognitive beliefs you have to deal with</span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">For example</span><br /><blockquote class="tr_bq"><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">Self-criticism keeps me from being selfish and lazy</span></blockquote><span style="background-color: white; color: #222222; font-family: arial, sans-serif;"><br /></span><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">&nbsp;To discover your client's specific beliefs about the benefits of self-criticism ask them</span><br /><blockquote class="tr_bq"><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">"What concerns would you have about the possibility of not being self-critical at all?" </span></blockquote><span style="background-color: white;">You need to challenge beliefs about the benefits of self-criticism.&nbsp;</span><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">Remind them &nbsp;that compassionate people like Nelson Mandela are strong. Ask them if they would like their self-critic to be the teacher of a child they loved who was struggling with maths. Tell them that their aim is not to lose self-control and do whatever they like, but to replace the harsh self-critic (the<a href="http://www.get.gg/parrot.htm" target="_blank"> "poisoned parrot</a>") with&nbsp;</span><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">&nbsp;a gentle compassionate internal self-corrector &nbsp;- perhaps like Dumbledoore.&nbsp;</span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;"><br /></span><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">9. It's helpful to use metaphors and stories.</span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">This &nbsp;<a href="http://simplelifestrategies.com/slsbadwolf/" target="_blank">Native American story</a>&nbsp;about feeding the good wolf can help foster hope and the realisation that CFT takes practice in compassion - and also the idea that it compassion is a choice.</span><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;"><br /></span><span style="background-color: white; color: #222222; font-family: arial, sans-serif;"><br /></span><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">10. There is growing evidence for the effectiveness of CFT. Most of the evidence comes from group CFT and as yet there are no randomised control trials. So whilst CFT promises to help with some of the difficult cases that CBT finds most tricky, it would be premature to abandon CBT altogether.</span><br /><br /><br /><span style="background-color: white; color: #222222; font-family: arial, sans-serif;">You can learn more about Compassion Focussed Therapy and get lots of free downloads and other resources at&nbsp;</span><a href="http://compassionatemind.co.uk/" style="background-color: white; color: #1155cc; font-family: arial, sans-serif;" target="_blank">Compassionatemind.co.uk</a>. This link provides many useful and free&nbsp;<a href="http://www.compassionatemind.co.uk/14.html" target="_blank">Scales</a><br /><br /><br /><br /><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
Visit http://www.timlebon.com/consultations.htm
Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2013/03/10-things-i-learnt-from-compassion.htmlnoreply@blogger.com (Tim LeBon)3tag:blogger.com,1999:blog-4642274826047849093.post-8946652733685294829Sun, 03 Mar 2013 19:27:00 +00002013-03-03T19:28:49.709+00:00beckCBTcbt interviewhistory of CBTJudith BeckA Conversation with Aaron T. Beck<iframe allowfullscreen="" frameborder="0" height="270" src="http://www.youtube.com/embed/POYXzA-gS4U" width="480"></iframe><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
Visit http://www.timlebon.com/consultations.htm
Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2013/03/a-conversation-with-aaron-t-beck.htmlnoreply@blogger.com (Tim LeBon)0tag:blogger.com,1999:blog-4642274826047849093.post-2237211733159207577Thu, 14 Feb 2013 10:28:00 +00002013-02-14T10:29:24.089+00:00anxietyGADjealousymetacognitiveOCDrelationshipssuspicionworryCBT for jealousy and suspicion<br /><div style="background-color: white; border: 0px; color: #333333; font-family: Arial, Helvetica, sans-serif; font-size: 14px; line-height: 22px; margin-top: 10px; outline: none; padding: 0px;">&nbsp;“O, beware, my lord, of jealousy;</div><div class="MsoNormal" style="background-color: white; border: 0px; color: #333333; font-family: Arial, Helvetica, sans-serif; font-size: 14px; line-height: 22px; margin-top: 10px; outline: none; padding: 0px;">It is the green-eyed monster, which doth mock</div><div class="MsoNormal" style="background-color: white; border: 0px; color: #333333; font-family: Arial, Helvetica, sans-serif; font-size: 14px; line-height: 22px; margin-top: 10px; outline: none; padding: 0px;">The meat it feeds on.”</div><div class="MsoNormal" style="background-color: white; border: 0px; color: #333333; font-family: Arial, Helvetica, sans-serif; font-size: 14px; line-height: 22px; margin-top: 10px; outline: none; padding: 0px;">― William Shakespeare, Othello</div><div class="MsoNormal" style="background-color: white; border: 0px; color: #333333; font-family: Arial, Helvetica, sans-serif; font-size: 14px; line-height: 22px; margin-top: 10px; outline: none; padding: 0px;"><br /></div><br />I recently had an article published on how to use <a href="http://blog.naturaltherapyforall.com/2013/02/06/5-top-tips-to-reduce-jealousy-and-suspicion-in-romantic-relationships/" target="_blank">CBT to overcome jealousy and suspicion</a><br /><br />From a clinical perspective, jealousy has similarities with both OCD and GAD and I find<br />a metacognitive approach helpful.<br /><br />It's certainly a common problem and will sometimes be the underlying problem in referrals for depression and anxiety so its definitely worth having some ideas up your sleeve regarding how to work with such clients.<br /><br />To find out more click on this link<br /><a href="http://blog.naturaltherapyforall.com/2013/02/06/5-top-tips-to-reduce-jealousy-and-suspicion-in-romantic-relationships/">http://blog.naturaltherapyforall.com/2013/02/06/5-top-tips-to-reduce-jealousy-and-suspicion-in-romantic-relationships/</a><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
Visit http://www.timlebon.com/consultations.htm
Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2013/02/cbt-for-jealousy-and-suspicion.htmlnoreply@blogger.com (Tim LeBon)10tag:blogger.com,1999:blog-4642274826047849093.post-3396335291600124645Wed, 13 Feb 2013 11:19:00 +00002013-02-24T22:06:56.948+00:00anxietycompassiondepressioned watkinsflowfunctional analysisproblem-solvingRFCBTruminationworry10 things I learnt from Ed Watkins workshop on CBT to Treat Depressive and Anxious RuminationYesterday I attended an extremely &nbsp;useful workshop given by Professor Ed Watkins from the University of Exeter yesterday about how &nbsp;Rumination-Focussed Cognitive Behavioural Therapy (RFCBT) can help clients with both depression and anxiety-related disorders.<br /><br />In this post I will present<b> 10 things I learnt about RFCBT</b><br /><br />1) <b>Worry and Rumination are quite similar </b>- the main difference is that worry tends to be future-oriented and rumination past-oriented. "Repetitive thinking" (RT) can be used to cover both processes; clinically you should use whatever term makes sense to the client. &nbsp;Clients may talk about "dwelling on", "brooding", "going over things again and again", "stewing on things", "chewing things over", "procrastinating" - notice what term they use and stick with it.<br /><br />2) <b>Repetitive thinking</b> is often a key pathological process. &nbsp;It can maintain both anxiety and depression. Consequently identifying it, labelling it, and changing it can be a key step in shifting depression and anxiety<br /><br />3) Rumination and worry can be thought of as part of <b>avoidance</b> which is known to be part of both depression and anxiety. Rumination and worry tend to involve withdrawal from others, reduced activity and taking less risk - all characteristics of major depression. Worrying can be an alternative to confronting the thing one is worried about.<br /><br />4) Rumination and worry are quite normal - we all do it - and <b>need not always be unhelpful</b>. Whereas Adrian Wells's Metacognitive Therapy (MCT) tends to view all rumination and worry as pathological, Watkins' RFCBT appears more attuned to the possibility that there is some purpose to it, and sometimes it may actually be helpful. Even if it is not helpful, its useful to identify its aim &nbsp;(Padesky's there's a good reason for what you are trying to do idea) and substitute more helpful ways of achieving this goal.<br /><br />5) <b>Functional analysis</b> is a key technique in determining the purpose and nature of rumination and worry for an individual client<b>. Functional analysis</b> involves identifying the antecedents, behaviours and consequences (ABC) of the problem (in this case repetitive thinking). <br /><b>Antecedents -</b> &nbsp;"tell me about a recent time when you found yourself chewing things over. What kicked it off? what did you notice first? what was going on in your body? where were you? what was going through your mind? who were you with?" These are all good questions to elicit the antecedents.<br /><b>Behaviour </b>- "what happened next? how &nbsp;long did it last? what ended it? were you thinking about the past a lot? were you trying to figure out the meaning of things? (rumination) were there a lot of what-ifs? (worrying)<br /><b>Consequences </b>"Did it help? In what ways was it useful? In what ways was it not useful? What was it trying to achieve? What happened as a result? Did you feel different? What were the long-term consequences? What would you like to happen? I this way both the positive and negative consequences of repetitive thinking can be identified.<br />Functional analysis begins in the assessment session and may be augmented by asking the client to keep a diary. The diary would focus on the problem behaviour. Notice that rumination and worry are treated as behaviours.<br /><br />6) Functional analysis will draw out the range of repetitive thinking which the client is currently doing. It will also clarify for both client and therapist the ways in which it is helpful or unhelpful. Most often the helpful parts which actually be <b>problem-solving, planning or decision-making</b>. It may be that sometimes it may be useful to come to terms with a loss, or be part of a grieving process. &nbsp;In this way RFCBT can be seen as being a guided discovery towards something like Butler and Hope's <a href="https://www.google.co.uk/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=1&amp;cad=rja&amp;sqi=2&amp;ved=0CDEQFjAA&amp;url=http%3A%2F%2Fwww.mhco.org.uk%2Ffiles%2FTherapy_Templates%2FMHCO545.pdf&amp;ei=enUbUcbmE8bM0AW97YCoBA&amp;usg=AFQjCNEoMiS4QbGCyQFv8pWPnwDiKE2Qjg&amp;sig2=Lu60ZCvrllEDEAwHTQalyA&amp;bvm=bv.42261806,d.d2k" target="_blank">Worry Decision Tree. </a>A logical follow-up will be further worked aimed at<br />1) distinguishing between unhelpful and helpful repetitive thinking<br />2) reducing the unhelpful processes (unhelpful repetitive thinking)<br />3) coaching in planning, problem-solving and decision-making<br /><br />7) Repetitive thinking is best explained as a <b>bad or unhelpful habit.</b><br />Framing RT as a habit is very often a useful way of socialising clients into RFCBT. We all have bad habits and we all know that they can be difficult to change, but they can be changed. &nbsp;This way of thinking about RT gives the right message.<br /><blockquote class="tr_bq">&nbsp;Rumination and worry are generally unhelpful, and you can change them, and we will need to work to change them, and it may require quite a lot of practice.</blockquote>&nbsp;An alternative message given in more mindfulness-based approaches would be that of a skill - that learning to ruminate or worry less is like learning a new skill).<br /><br />8) RFCBT proposes a<b> number of ways to reduce unhelpful repetitive thinking.</b><br />These include<br />i) Becoming more aware of the triggers<br />This follows from the "A" part of &nbsp;functional analysis. For example, a client may notice that a trigger to rumination is being on their own on their walk to work.<br />ii)Altering environmental contingencies<br />For example, the above client may be encouraged to try out listening to cheerful music on their way to work..<br />iii) Changing processing style<br />Repetitive thinking involves abstract and very often uncompassionate thinking. can be countered by exploring flow experiences (point 8) and learning to be more compassionate (point 9)<br /><br />9) Modelling and scheduling<b> experiences of deep absorption and engagement (<a href="http://www.timlebon.com/FlowPsychologyCsikszentmihalyi.html" target="_blank">flow</a>)</b> can provide an effective contrast to repetitive thinking. &nbsp;Ask the client to recall an experience of deep absorption - it may be doing a sport, a hobby or at work. You can then either schedule more activities like that (flow activities scheduling) or help the client get back in touch with those feelings using imagery.<br />a) Ask the client to notice &nbsp;the triggers of rumination or worry<br />b ) Get back in touch with their &nbsp;flow experience -<br />c) Return to the task that was interrupted by the rumination or worry.<br />In this way recreating the flow experience in imagination is not just a distraction &nbsp;- it is teaching the client to get back in touch with a very concrete, focussed processing style which they can use to be more effective.<br /><br />10)<b> Compassionate Mind &nbsp;training </b>is another way to change thinking style in a helpful way. Many ruminators and worriers are self-critical. If they can learn to be kinder to themselves, this will change their style of thinking. Paul Gilbert and Deborah Lee have done a lot of work &nbsp;on compassionate mind training, for example involving developing an image of the <a href="https://www.google.co.uk/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=2&amp;cad=rja&amp;sqi=2&amp;ved=0CDkQFjAB&amp;url=http%3A%2F%2Fdoi.apa.org%2F%3Fuid%3D2005-13871-011&amp;ei=TXUbUbHNMcmn0QXnm4CgBQ&amp;usg=AFQjCNHdn81hOWhWeAjZze-AMr6mPZLZvw&amp;sig2=WksKuEes9f1kt8XypOVxIA&amp;bvm=bv.42261806,d.d2k" target="_blank">"perfect nurturer"</a> and bringing it to mind when you need it. RFCBT's approach is slightly different in that it involves real experiences of compassion - for example when they had been compassionate to some else. Through imagery work the client is invited to get in touch with the feelings and thoughts of compassion. They can then practice this through homework and work through a hierarchy of more difficult times to bring compassion. Often it will be hardest to be self-compassionate in which case this will be at the top of the hierarchy.<br /><br /><b>To sum up:-</b><br /><b>&nbsp;RFCBT is an evidence- based, short-term trans-diagnostic approach</b> which can help with depression and anxiety. It can almost certainly also be useful in dealing with other problems such as PTSD and anger-management. &nbsp;Many of its techniques (functional analysis, guided discovery, behavioural experiments, imagery, homework setting, exposure hierarchy will be familiar to the CBT practitioner. It also has similarities but also differences with Wells's Megacognitive Approach, Gilbert's Compassion-Focussed therapy, Butler and Hopes Worry Tree and Positive Psychotherapy approaches enhancing flow and engagement.<br /><br />You can find out more about Ed Watkin's Rumination Focussed CBT by following these links<br /><a href="http://www.southampton.ac.uk/mind/pdfs/Edward%20Watkins.pdf" target="_blank">Ed Watkins Powerpoint Presentation of RFCBT</a>&nbsp;(pdf)<br /><a href="http://www.psychologytoday.com/files/attachments/84564/cbtfordepressiveruminationpaperscientistpractitioner.pdf" target="_blank">Ed Watkins paper of depressive rumination</a><br /><a href="http://www.psychologytools.org/rumination-focused-cognitive-behavioural-therapy-rfcbt.html" target="_blank">Psychology tools resources on rumination</a><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
Visit http://www.timlebon.com/consultations.htm
Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2013/02/10-things-i-learnt-from-ed-watkins-cbt.htmlnoreply@blogger.com (Tim LeBon)4tag:blogger.com,1999:blog-4642274826047849093.post-1629152261075657431Mon, 18 Jun 2012 19:53:00 +00002012-06-18T20:58:43.948+01:00CBTdonald robertsonpositive data logpositive psychologyresilienceself-esteemseligmanstoicismstrengthsGuest Post - Focus on Personal Strengths by Donald Robertson<br /><h1 style="background-color: transparent; border: 0px; clear: both; color: #761594; font-size: 28px; margin: 0px 0px 0.8125em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><br /></h1><h2 style="background-color: transparent; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.8125em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> Positive Psychology and Resilience Building</h2><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><a href="http://www.amazon.co.uk/exec/obidos/ASIN/1444168711/solulondcognt-21" style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; color: #761594; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline; word-wrap: break-word;" target="_blank" title="Build your Resilience on Amazon"><img align="right" alt="Build your Resilience" border="0" height="244" src="http://londoncognitive.com/wp-content/uploads/2012/06/Teach-Yourself-Resilience1.jpg" style="background-image: none; border: 0px; display: inline; float: right; height: auto; margin: 0px; max-width: 100%; padding-left: 0px; padding-right: 0px; padding-top: 0px;" title="Build your Resilience" width="163" /></a>Copyright<a href="http://www.londoncognitive.com/" target="_blank"> Donald Robertson</a>, 2011.&nbsp; All rights reserved.&nbsp;</div><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">[This chapter was originally intended for my book&nbsp;<a href="http://www.amazon.co.uk/exec/obidos/ASIN/1444168711/solulondcognt-21" style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; color: #761594; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline; word-wrap: break-word;" target="_blank" title="Build your Resilience">Build your Resilience</a>&nbsp;(2012) but was later replaced by a different approach.&nbsp; It assumes that&nbsp;<a href="http://en.wikipedia.org/wiki/Martin_Seligman" style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; color: #761594; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline; word-wrap: break-word;" target="_blank" title="Martin Seligman on Wikipedia">Martin Seligman’s</a>&nbsp;work on&nbsp;<a href="http://en.wikipedia.org/wiki/Positive_psychology" style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; color: #761594; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline; word-wrap: break-word;" target="_blank" title="Positive Psychology on Wikipedia">Positive Psychology</a>&nbsp;and&nbsp;<a href="http://en.wikipedia.org/wiki/Psychological_resilience" style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; color: #761594; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline; word-wrap: break-word;" target="_blank" title="Psychological Resilience on Wikipedia">resilience-building</a>&nbsp;programmes like the Penn Resilience Program (PRP) have been briefly introduced in introductory parts of the book, along with some references to CBT approaches to resilience training.<span style="background-color: white;">It was originally published at&nbsp;</span><a href="http://londoncognitive.com/2012/06/09/personal-strengths-resilience-building/" style="background-color: white;">http://londoncognitive.com/2012/06/09/personal-strengths-resilience-building/</a><span style="background-color: transparent;">and is reprinted here with permission of the author]</span><span style="background-color: transparent;">]</span></div><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">In this chapter you will learn:</div><ul style="background-color: transparent; border: 0px; list-style-image: none; list-style-position: outside; margin: 0px 0px 1.5em 1.15em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What personal “<i>signature strengths</i>” are and their role in building emotional resilience</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">How to reliably&nbsp;<i>identify</i>&nbsp;and&nbsp;<i>assess</i>&nbsp;your own signature strengths</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">How to systematically&nbsp;<i>evaluate</i>&nbsp;your strengths and weaknesses</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">How to make&nbsp;<i>better use</i>&nbsp;of your strengths in daily life and in overcoming adversity</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">How to&nbsp;<i>build your strengths</i>&nbsp;and overcome your weaknesses</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">How to&nbsp;<i>integrate</i>&nbsp;a “strengths focus” with the other aspects of resilience-building you’re learning</li></ul><blockquote style="background-color: transparent; border: 0px; font-style: italic; margin: 0px 3em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">The greatest good for man is to talk every day about virtue and the other things about which you hear me talking and examining myself and others… the unexamined life is not worth living. – Socrates</div></blockquote><h3 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> The Importance of Personal Strengths</h3><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Have you examined your own strengths and virtues? What character traits have seen you through problems in the past? What personal qualities might you need to fall back on in times of great adversity to come? What inner resources might contribute to your emotional resilience? The goal of this chapter is to help you assess and make better use of your personal strengths as a way of enhancing resilience, something that will stand you in good stead when you begin to use the techniques in subsequent chapters. Knowing your own strengths from the outset will help you to make better use of&nbsp;<i>every other resilience-building technique</i>.</div><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">In recent years, increasing emphasis has been placed on the importance of identifying and making better use of personal character strengths, particularly by researchers involved in the “Positive Psychology” movement, whose work we’ve encountered in previous chapters. One of the pioneers of Positive Psychology, Professor Martin Seligman, is also a leading expert on emotional resilience training. So it’s no surprise that this “strengths focus” has become part of modern approaches to resilience-building, although it was not so prominent in the past. Popular wisdom tells us that we should “play to our strengths” and that philosophy has indeed been found to serve well as a basis for building psychological fitness and coping with adversity.</div><blockquote style="background-color: transparent; border: 0px; font-style: italic; margin: 0px 3em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">The strengths and virtues […] function to buffer against misfortune, and against the psychological disorders, and they may be the key to building resilience. (Seligman M. E., 2002, p. xiv)</div></blockquote><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Seligman’s research has provided evidence that the “signature strengths exercise”, employed in Positive Psychology was one of the most effective methods of lowering depression and increasing rating of happiness, and that the effects typically lasted at least six months, especially when the techniques were used repeatedly over time (Seligman, 2011, p. 38). You’ll learn similar concepts and techniques in this chapter as a means of enhancing your emotional resilience. Although psychologists have increasingly emphasised the value of focusing on<i>strengths</i>&nbsp;rather than&nbsp;<i>weaknesses</i>, evaluation of weaknesses and how they can be improved may come later. By first focusing upon and developing your core strengths, you will subsequently be in a better (stronger) position to tackle your weaknesses and making creative use of your strengths may help you to do so.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> ‘Key idea’: Strengths Focus</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Recent decades have seen a shift toward greater focus among psychologists upon personal&nbsp;<i>strengths,&nbsp;</i>positive character traits<i>,</i>&nbsp;and resources, referred to as the “Positive Psychology” movement. Spending time focusing your attention on particular aspects of experience tends to shape things in certain directions. Focusing on your personal flaws or weaknesses can be helpful in some cases, if you learn to change them, but it can also be depressing if it continues for too long. Focusing on strengths and positive qualities tends to be immediately rewarding, it makes you feel good. When those good feelings are linked to constructive action, attempts to make better use of your strengths in life, you may begin to flourish as a result and achieve longer-term improvements in your quality of life and ability to cope resiliently with setbacks.</div><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">There’s a growing consensus that focusing on personal strengths can contribute to building emotional&nbsp;<i>resilience</i>. The Master Resilience Training (MRT) programme developed by Seligman and others for the US military, follows training in basic “emotional toughness” (resilience) skills with training in identifying personal character strengths (Seligman, 2011, p. 171). Some cognitive therapists, such as Christine Padesky, whose work we’ve encountered in previous chapters, have likewise placed the concept of personal strengths at the heart of their approach to resilience-building: “Resilience describes how people use their strengths to negotiate adversity” (Kuyken, Padesky, &amp; Dudley, 2009). In the absence of immediate problems, moreover, focusing on building strengths may seem a more natural goal than spotting weaknesses or preparing to cope with hypothetical adversities in the future, although these are all important aspects of resilience-building.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> ‘Remember this’: Start by Building Strengths</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">A good way to begin building resilience is to by focusing initially on your psychological strengths and resources. You need to prepare your weapons and armour before going into battle. It’s quite enjoyable to study your positive qualities and how they could be put to better use. Keep an eye out for evidence of your strengths in action at all times though because doing so will help you to gain self-confidence, grow stronger, and learn how to make better use of your most important qualities.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> Assessing your Personal Signature Strengths</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What traits do you most value in yourself and others? If you were to draw a list of the five most important qualities that a human being can possess, what would they be? Of course, people have thought about this quite a lot already! The English word “virtue” comes from the Latin word (<i>virtus</i>) for “strength” or “manliness” and originally alluded to those positive qualities thought to make a man (or woman) excel in their essential nature, i.e., character strengths. In ancient Greek and Roman culture there was a well-known list of four “cardinal virtues”: “<i>courage”</i>, “<i>temperance”&nbsp;</i>(or self-discipline), “<i>justice”</i>&nbsp;(or integrity), and “wisdom.” Thousands of years later the same cardinal virtues are incorporated into the main questionnaire used in Positive Psychology and evidence-based resilience training programmes (see below). However, these are just generalisations and guidelines; it’s ultimately down to every individual to decide what they consider to be important character strengths based on their own&nbsp;<i>personal</i>&nbsp;values.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> The VIA Questionnaire</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">In Seligman’s approach, strengths are evaluated using the Values in Action (VIA) Signature Strengths questionnaire, designed by Professor Chris Peterson at the University of Michigan. The VIA questionnaire is a particularly valuable assessment tool, having been used extensively in research on Positive Psychology and resilience-building. It has been made available online, free-of-charge as a “public service”, at Seligman’s&nbsp;<i>Authentic Happiness</i>&nbsp;website:&nbsp;<a href="http://www.authentichappiness.org/" style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; color: #761594; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline; word-wrap: break-word;">www.authentichappiness.org</a>. You should register on the site and complete the questionnaire right now if possible. It provides an excellent, well-established, starting point for the evaluation of personal signature strengths. Once you’ve answered the questions online, you’ll be provided with a printable set of results, ranking the “strengths” in the order which your responses suggest they apply to you. There’s also an abbreviated version of the questions in the appendix of Seligman’s recent book,&nbsp;<i>Flourish</i>&nbsp;(2011).</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> ‘Remember this’: Review your List</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">There’s no value in assessing your personal strengths only to forget about them. Once you have an initial list, keep reviewing it periodically. Doing so will help you both to memorise it and refine it. Using the other questions and techniques to evaluate your strengths, monitoring them in action, and making time to put them into practice in new ways, will help you to become more and more familiar with them. The goal is to know your own strengths like the back of your hand and to make the best of them.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> Questions from Cognitive Therapy</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">There are actually many useful ways to start assessing your own strengths. Even if you don’t have access to the VIA questionnaire or choose not to use this method, there are plenty of other ways to help identify your personal signature strengths. It’s been found to help if you make a point of considering even qualities that might seem small or trivial to you, as these often provide important clues to hidden strengths. Likewise, your greatest strengths might be qualities you’re simply taking for granted. The following list of questions is adapted from two well-known cognitive therapy approaches from Melanie Fennell’s&nbsp;<i>Overcoming Low Self-Esteem&nbsp;</i>(1999, p. 127) and Judith Beck’s&nbsp;<i>Cognitive Therapy: Basics &amp; Beyond</i>&nbsp;(1995, p. 181).</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> ‘Try it now’: Questions about Personal Strengths</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Try to answer as many of the questions below as you can, in as much detail as possible, to help paint an initial picture of your key personal strengths and positive qualities. Don’t worry if you find you’re repeating yourself, just skip to the next question.</div><ol style="background-color: transparent; border: 0px; list-style-position: outside; margin: 0px 0px 1.5em 1.4em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What personal strengths or positive qualities do you possess?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What do you like or value about yourself, however small?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What have you achieved in your life, however small?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What challenges or problems have you overcome and how did you manage to do it?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What gifts or talents do you have, however modest?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What skills have you acquired during the course of your life?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What do other people like or value about you?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What qualities that you value in other people do you share?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What positive qualities do you value and try to possess, regardless of whether you think you’ve sufficiently achieved them?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What aspects of yourself or your actions would you appreciate if they were qualities of another person?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What small positive characteristics could you possibly be discounting or overlooking in yourself?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What bad things are you&nbsp;<i>not</i>? What flaws, vices, or weaknesses do you&nbsp;<i>not&nbsp;</i>have? How are you different from someone who has those flaws?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">How might another person who cared about you describe your best qualities?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">When your self-esteem is at its strongest, what is going on? What are you like when feeling self-confident and functioning at your best?</li></ol><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Finish by trying to write a brief list summarising your core strengths, drawing on your responses to the questions above.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> Learning from Past Experience</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Another way to identify your personal strengths is to analyse specific situations from your past in more detail, perhaps your proudest moments or greatest achievements. Write an account of a specific challenging situation, telling the story of how your personal strengths have helped you to cope with adversity or solve a problem. The questions below are designed to help you evaluate your problem-solving retrospectively and identify the personal strengths that contributed to your resilience in the past.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> ‘Try it now’: Questions about Previous Situations</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Answer the questions below in relation to a past situation where you&nbsp;<i>successfully</i>&nbsp;overcame a significant challenge and exhibited personal resilience,</div><ol style="background-color: transparent; border: 0px; list-style-position: outside; margin: 0px 0px 1.5em 1.4em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What specifically was the problem and why was it a problem?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What was your goal, what were you trying to achieve? What was the actual outcome?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What obstacles, challenges, or setbacks did you have to overcome?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What specifically did you do, in terms of your behaviour, to overcome these things and achieve your goal?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What specific thoughts and attitudes helped you to succeed?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">How would you rate your resilience in that situation from 0-100%?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Why wasn’t it 0%? What strengths and personal qualities helped you?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">If it wasn’t 100%, how could your resilience be improved during similar situations in the future?</li></ol><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">If you want, repeat these questions for several situations and build up a cumulative picture of the strengths employed by you to overcome different problems.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> Characteristics of “Signature Strengths”</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Some strengths may be more important or central to your character than others. Once you’ve identified an initial list of your strengths using the VIA questionnaire or the other methods above, you should consider which ones most closely fit the following criteria for being a personal “<i>signature</i>&nbsp;strength” (Seligman, 2011, pp. 38-39),</div><ul style="background-color: transparent; border: 0px; list-style-image: none; list-style-position: outside; margin: 0px 0px 1.5em 1.15em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">It feels authentic, part of the “real you”</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">You feel enthusiasm and excitement about using it, especially if you’re not used to doing so</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Learning quickly accrues from using the strength as you tap into something that feels right</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">You experience a desire to find creative new ways to use your strength</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">You feel a sense of “inevitability” as if you are bound to do what comes naturally in using your strength</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">You feel energised by using the strength rather than exhausted</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">You create personal goals based upon it</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">You experience an abundance of positive, energising sensations and emotions when using your signature strength fully</li></ul><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Your signature strengths are those, according to Seligman, which should initially receive the most attention as they’re likely to be your most powerful psychological assets and may generate a momentum of their own once you begin to become more aware of them and make more extensive use of them.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> ‘Key idea’: Signature Strengths</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Everyone has positive qualities and strengths. However, some of your personal strengths are particularly important because they may be central to your personality and have an “authentic” quality to them, which makes you feel like you’re being true to yourself when you’re using them to the best of your ability. These “signature strengths” may coincide with your core values in life and you may even feel you’re fulfilling your destiny or answering your calling in life by using them more fully.</div><h3 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> Evaluating your Strengths</h3><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> Reflecting on your own Strengths</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Once you’ve developed an initial list of your key strengths and identified which ones are most important, possible “signature strengths”, it can be useful to reflect on your strengths in more detail. Your initial list is probably just a rough draft and awareness of your strengths may become clearer over time as you make an effort to focus on them and observe them in action in your daily life.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> ‘Try it now’: Reflecting on Personal Strengths</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Try to answer the questions below by reflecting on the work you’ve done so far to assess your personal strengths.</div><ol style="background-color: transparent; border: 0px; list-style-position: outside; margin: 0px 0px 1.5em 1.4em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What have you learned from about your strengths from the questions and exercises above?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">How did you actually acquire these strengths?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">How do you typically use your strengths to deal with problems?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">How do your strengths influence your relationships with other people?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Does using these strengths too much ever cause problems? How can you prevent or minimise this?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">How could you make better use of your strengths in daily life?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What would happen if you made more use of your key strengths? What impact might it have on your life in general?</li></ol><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> The Positive Data Log: Raising Awareness of Strengths in Action</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">So far you’ve been considering resilience from a general perspective but now it’s time to begin looking more closely at specific examples of your strengths in action, on a daily basis. A common technique in cognitive therapy, called the “Positive Data Log”, involves keeping a running log of specific events that provide cumulative evidence supporting a positive belief the client is trying to adopt (Padesky, 1994). Sometimes a similar method is used to record any evidence of positive qualities or personal strengths, in general, to help build self-esteem (Fennell, 1999). Part of the reason for doing this is that when people are depressed they appear to automatically overlook or forget about positive events and to pay more attention to negative experiences. Keeping a Positive Data Log entails making a conscious and systematic effort to pay more attention to evidence of positive qualities,&nbsp;<i>no matter how small or apparently insignificant</i>. The underlying purpose is to retrain the mind to&nbsp;<i>automatically</i>&nbsp;pay more attention to these events and remember them and to overcome negative&nbsp;<i>biases</i>&nbsp;in thinking, memory, and attention, where these are responsible for problems with low mood or self-esteem. The Positive Data Log can be used by anyone though and provides another way of monitoring and increasing awareness of personal strengths.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> ‘Key idea’: Focus of Attention</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">People tend to automatically focus attention in ways that are influenced by their existing beliefs and assumptions. For example, someone who is anxious and believes they are vulnerable to harm will tend to, automatically and perhaps without realising they are doing so, focus their attention on possible signs of danger in their environment, noticing even the slightest cause for worry, that other people might overlook. Someone who suffers from hypochondria and believes he is ill will scan his body looking for unusual sensations, symptoms, and notice even the faintest twinge of pain, which wouldn’t catch the attention of another person. Keeping a written log recording specific events on a daily basis is an excellent way to train your mind to notice and remember things that it may have previously overlooked. In this chapter, we’re interested in how keeping a log could be used to enhance awareness of personal strengths and the evidence of them in action on a day-by-day basis.</div><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">The Positive Data Log usually contains an ongoing record of specific events which can provide evidence for general strengths or positive qualities, noted in a second column. For example, a couple of entries from a running log, spanning two days, might look as follows, containing&nbsp;<i>specific</i>&nbsp;events in one column and the&nbsp;<i>general</i>&nbsp;strengths they provide evidence of in the other,</div><table border="1" cellpadding="0" cellspacing="0" style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(231, 231, 231); margin: 0px -1px 24px 0px; outline: 0px; padding: 0px; text-align: left; vertical-align: baseline; width: 907px; word-wrap: break-word;"><tbody style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><tr style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><td style="background-color: transparent; border-color: rgb(231, 231, 231) rgb(170, 170, 170) rgb(170, 170, 170); border-style: solid none none; border-width: 1px; margin: 0px; outline: 0px; padding: 6px 24px; vertical-align: baseline; word-wrap: break-word;" valign="top" width="712"><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><b>Positive Data Log</b></div></td></tr><tr style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><td style="background-color: transparent; border-color: rgb(231, 231, 231) rgb(170, 170, 170) rgb(170, 170, 170); border-style: solid none none; border-width: 1px; margin: 0px; outline: 0px; padding: 6px 24px; vertical-align: baseline; word-wrap: break-word;" valign="top" width="395"><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><b>Specific Events</b></div></td><td style="background-color: transparent; border-color: rgb(231, 231, 231) rgb(170, 170, 170) rgb(170, 170, 170); border-style: solid none none; border-width: 1px; margin: 0px; outline: 0px; padding: 6px 24px; vertical-align: baseline; word-wrap: break-word;" valign="top" width="317"><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><b>General Strengths / Positive Qualities</b></div></td></tr><tr style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><td style="background-color: transparent; border-color: rgb(231, 231, 231) rgb(170, 170, 170) rgb(170, 170, 170); border-style: solid none none; border-width: 1px; margin: 0px; outline: 0px; padding: 6px 24px; vertical-align: baseline; word-wrap: break-word;" valign="top" width="395"><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><i>Saturday 9<sup style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; bottom: 1ex; font-size: 13px; height: 0px; margin: 0px; outline: 0px; padding: 0px; position: relative; vertical-align: baseline; word-wrap: break-word;">th</sup>&nbsp;July 2011</i></div><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">1. Completed essay well before deadline for university.</div><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">2. Made up with boyfriend after argument.</div></td><td style="background-color: transparent; border-color: rgb(231, 231, 231) rgb(170, 170, 170) rgb(170, 170, 170); border-style: solid none none; border-width: 1px; margin: 0px; outline: 0px; padding: 6px 24px; vertical-align: baseline; word-wrap: break-word;" valign="top" width="317"><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">1. Patience, self-discipline, good organisation</div><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">2. Forgiveness, assertiveness</div></td></tr><tr style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><td style="background-color: transparent; border-color: rgb(231, 231, 231) rgb(170, 170, 170) rgb(170, 170, 170); border-style: solid none none; border-width: 1px; margin: 0px; outline: 0px; padding: 6px 24px; vertical-align: baseline; word-wrap: break-word;" valign="top" width="395"><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><i>Sunday 10<sup style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; bottom: 1ex; font-size: 13px; height: 0px; margin: 0px; outline: 0px; padding: 0px; position: relative; vertical-align: baseline; word-wrap: break-word;">th</sup>&nbsp;July 2011</i></div><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">1. Cleaned out the garage finally.</div></td><td style="background-color: transparent; border-color: rgb(231, 231, 231) rgb(170, 170, 170) rgb(170, 170, 170); border-style: solid none none; border-width: 1px; margin: 0px; outline: 0px; padding: 6px 24px; vertical-align: baseline; word-wrap: break-word;" valign="top" width="317"><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">1. Patience, perseverance, self-discipline</div></td></tr></tbody></table><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">This record should be maintained for several weeks, at least, and events should ideally be noted down as soon as they happen, in case they’re forgotten. The more it’s used, the more automatically you should begin to notice evidence of personal strengths and store them in your memory. Having an initial list of personal strengths, from the VIA or the cognitive therapy questions above, will help you know what sort of events to be on the lookout for. However, as you record events, you’ll probably begin to recognise that you have other strengths, or to define your strengths more clearly. Having the patience to write things down will pay dividends as the process of writing requires more attention and is believed to help your brain become more attuned to further evidence in the future, which might otherwise have been overlooked.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> Assessing the Strengths of Others</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Strengths and weaknesses don’t only apply to individuals. In some contexts, of course, these ideas and techniques can be applied to groups, teams, organisations, etc., perhaps even couples in relationships. For example, an organisation may find it lacks creativity, although a particular individual within the group may have that strength, which could be better utilised by the others.</div><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Try developing what Seligman calls a “family tree” of strengths by encouraging your friends and family to discuss personal strengths. If you’re able, try asking other people to summarise your key personal strengths and do the same for them. Note how your own self-appraisal may differ from other people’s perception of you. Obtaining information from others in this way can help to correct gaps or biases in your own perception of your strengths. Understanding other people’s strengths and weaknesses may help you to interact with each other more constructively. However, assessing the strengths of others can also be used for “modelling” or imitation. Indeed one of the best ways to develop your own strengths is by contemplating the strengths of others.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> ‘Remember this’: Learn from Others</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Focus on strengths isn’t just about your own virtues. There are many benefits to be obtained by carefully contemplating the strengths of other people. Most importantly, by putting into words what it is that you admire about other people’s resilience it makes it easier for you to remember and imitate their positive qualities yourself.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> Role-Models &amp; Contemplation of the Sage</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Try assessing the strengths of your heroes or role-models, real or fictional individuals. Think of someone you admire or a character who exhibits emotional resilience in the face of adversity. If it helps, begin by writing a short description or story highlighting their positive qualities. Then try to extract the essence of their strengths by summarising them in one or more short sentences. This could be a description of the key strength or a statement of the belief or philosophical principle that they seem to be following. For example,</div><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">In ancient philosophy, it was common practice to write about, discuss and contemplate the qualities of the ideal “Sage” or wise man and how he might act in different situations or overcome specific problems. The historical figure of Socrates was most often used as a living example of the ideal Sage – serving as a kind of “role-model” for ancient philosophers. The last days of Socrates, his trial and execution, were famously described in the “Dialogues” of his student Plato. If the philosopher Socrates were taken as an example, we might say he exhibited wisdom, of course, and great courage and equanimity, or temperance, in the face of adversity.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> ‘Try it now’: Learning from the Strengths of Others</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Think of a specific person whom you consider to be particularly resilient. This could be a real person that you know in life or even a fictional or historical character. Describe the key strengths that make them resilient.</div><ol style="background-color: transparent; border: 0px; list-style-position: outside; margin: 0px 0px 1.5em 1.4em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">How do you know they are resilient? What problem did they overcome and why was it a problem?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What goals were they trying to achieve? What was the actual outcome?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What obstacles, setbacks, or challenges did they have to overcome?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What specifically did they do, in terms of their behaviour, to overcome those things and achieve their goal?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What specific thoughts or attitudes do you suppose helped them?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">How would you rate their resilience overall in that situation from 0-100%?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Why wasn’t it 0%? What strengths and personal qualities helped them?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">If it wasn’t 100%, how could their resilience have been better?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What do you learn by considering their example? How might you put this into practice in your own life?</li></ol><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Repeat this exercise several times with different “role-model”, whether real people or fictional characters.</div><h3 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> Using your Signature Strengths</h3><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Set aside time within the next week or so to put one of your signature strengths into practice to the best of your ability, scheduling some<i>specific</i>&nbsp;event or activity that allows you to experiment with changing your behaviour. Try to think of creative ways to do this, going beyond the ways in which you already use your strengths to find new opportunities for them to be brought forward. It’s as if you’re asking yourself: “If this is what I’m good at doing then how can I make better use of it?” For example, if one of your signature strengths is that you have a strong “love of learning” then you might set aside time one evening to read in detail about a subject you’re interested in, if that’s not something you’d typically do with your time. On the other hand, if “appreciation of beauty” is one of your signature strengths, and you haven’t done so for a while, you might go out of your way to create an opportunity to visit the theatre or an art gallery and perhaps to share the experience with other people.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> ‘Try it now’: Experiment with Using Your Signature Strengths</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Write down a record of your experiment, noting how you felt before, during, what you learned from the experience and what you plan to do next.</div><ol style="background-color: transparent; border: 0px; list-style-position: outside; margin: 0px 0px 1.5em 1.4em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Where and when are you planning to carry out the experiment?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What signature strengths are you planning to use?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">How specifically do you plan to use them?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What exactly do you predict will happen?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">(Now do the experiment, using your signature strength!)</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What actually happened?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Rate how much pleasure you experienced by using your signature strengths (0-100%)?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Rate how much you experienced a sense of achievement by using your signature strengths (0-100%)?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">What have you learned by using your signature strength in this way? How could you get more out of it next time?</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">(If you’re keeping a Positive Data Log, use it to record any relevant information from this experiment, including evidence of any additional strengths.)</li></ol><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Try to schedule opportunities to use your signature strengths as frequently as possible as doing so will tend to help develop them further and benefit your mood and general sense of resilience. If you don’t use your strengths then you’re potentially wasting opportunities for growth and personal improvement. Make a deliberate effort to create time in your schedule to experiment with new ways to use your core strengths creatively.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> ‘Key idea’: Using Signature Strengths</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Using your signature strengths should be inherently rewarding, which is important because it means the more you do it, the more you want to do it again. That makes change potentially “self-reinforcing”, which is gold dust for therapy because change is usually bothersome and requires repeated effort to maintain. By using your signature strengths more fully you give yourself the opportunity to flourish and develop emotional resilience in ways that can seem completely natural and effortless, although some courage, patience, and effort may be required to begin with.</div><h4 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> Focus Points (Summary)</h4><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">The main points to remember from this chapter are,</div><ul style="background-color: transparent; border: 0px; list-style-image: none; list-style-position: outside; margin: 0px 0px 1.5em 1.15em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Focus on personal strengths is a valuable way of enhancing resilience</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">You can learn to focus on your strengths, identify them, evaluate them, and make better use of them</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Once you’ve identified an initial list of strengths you can use the Positive Data Log to monitor evidence of these and other strengths in action</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">You can develop your strengths further and improve your relationships by learning to identify and model the strengths of others</li><li style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Scheduling opportunities to actually use your signature strengths in creative new ways will help them develop and tends to be inherently rewarding</li></ul><h3 style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; clear: both; color: #761594; margin: 0px 0px 0.7em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;"> Works Cited</h3><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Fennell, M. J. (1999).&nbsp;<i>Overcoming Low Self-Esteem: A Self-Help Guide Using Cognitive Behavioral Techniques.</i>&nbsp;London: Robinson.</div><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Kuyken, W., Padesky, C. A., &amp; Dudley, R. (2009).&nbsp;<i>Collaborative Case Conceptualization: Working Effectively with Clients in Cognitive-Behavioral Therapy.</i>&nbsp;New York: Guilford.</div><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Padesky, C. A. (1994). Schema change processes in cognitive therapy.&nbsp;<i>Clinical Psychology and Psychotherapy, 1</i>(5), 267-278.</div><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Seligman, M. E. (2002).&nbsp;<i>Authentic Happiness: Using the New Positive Psychology to Realize your Potential for Lasting Fulfilment.</i>&nbsp;New York: Simon &amp; Schuster.</div><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Seligman, M. E. (2011).&nbsp;<i>Flourish: A New Understanding of Happiness and Well-being.</i>&nbsp;Nicholas Brealey: London.</div><div style="background-color: transparent; border: 0px; margin-bottom: 1.5em; outline: 0px; padding: 0px; vertical-align: baseline; word-wrap: break-word;">Copyright Donald Robertson, 2011.&nbsp; All rights reserved.&nbsp; </div><div class="snap_nopreview sharing robots-nocontent" style="background-color: transparent; background-position: initial initial; background-repeat: initial initial; border: 0px; margin: 0px; outline: 0px; padding: 0px 0px 10px; vertical-align: baseline; word-wrap: break-word;"><br /></div><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
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http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2012/06/guest-post-focus-on-personal-strengths.htmlnoreply@blogger.com (Tim LeBon)5tag:blogger.com,1999:blog-4642274826047849093.post-6172216566203175622Sun, 17 Jun 2012 09:00:00 +00002012-06-18T07:22:09.993+01:00CBThow not to do CBTskillsHow Not to Do CBT - Part 2<br /><div>In <a href="http://cbtfortherapists.blogspot.co.uk/2012/06/how-not-to-do-cbt-part-1.html" target="_blank">part 1 </a>of this series I showed one way that CBT can go wrong. In this post I will illustrate that there is more than one road to a therapy train crash! Here is a reminder of the client.<br /><blockquote class="tr_bq"><span style="font-family: Arial, Helvetica, sans-serif;">John comes to CBT because of his depression.&nbsp; He is a 40 year old who has recently been made redundant. He is worried about getting a job again and his redundancy has also&nbsp; caused tension in his marriage. When questioned about how he spends his time now, he says he gets up late, intends to look for jobs but ends up doing very little. He feels demotivated, discouraged and, at times, hopeless.&nbsp; He is having trouble sleeping and hints that he may be using drinking to cope with his difficulties.&nbsp; At times, he says, he wonders if he will ever get a job again.&nbsp; He sees his redundancy as meaning that he is a failure.&nbsp; He talks in&nbsp; a flat, slow monotone. As he talks, he is becoming more sad and more hopeless.</span></blockquote></div><div><div class="MsoNormal" style="margin-left: 36.0pt; text-indent: 36.0pt;"><b><u>How NOT to do CBT: Counsellor / Therapist &nbsp;B with John<o:p></o:p></u></b></div><div class="MsoNormal"><br /></div><div class="MsoNormal">B1: (<i>In a business-like tone</i>) Welcome back&nbsp; John, This is session 3 and today we are going to look at how being more active can help you be less depressed.&nbsp; Have you got your homework with you?<o:p></o:p></div><div class="MsoNormal">J1: Yes (<i>Gets sheet out of pocket)</i> – here it is.<o:p></o:p></div><div class="MsoNormal">B2: Right, so let’s see. Good, so on Wednesday you were more active and felt better. On Thursday you didn’t do much and felt worse. This supports what we know to be true in general, which is that when we are active we feel better and when we are less active we feel worse. Make sense?<o:p></o:p></div><div class="MsoNormal">J2: I guess so.<o:p></o:p></div><div class="MsoNormal">B3: There’s what we call a vicious cycle of depression <i>(Shows John handout &nbsp;“Vicious Circle of depression” )</i>. I’d like you to read this sheet as part of your homework, OK?<o:p></o:p></div><div class="MsoNormal">J3: Yes.<o:p></o:p></div><div class="MsoNormal">B4: So what we need to do is work out how we can get you more active in the next week.&nbsp; Do you ever go jogging?<o:p></o:p></div><div class="MsoNormal">J4: Not much.<o:p></o:p></div><div class="MsoNormal">B5: Swimming?<o:p></o:p></div><div class="MsoNormal" style="text-align: justify;">J5: No<o:p></o:p></div><div class="MsoNormal" style="text-align: justify;">B6: How about talking to friends? <o:p></o:p></div><div class="MsoNormal">J6: Well to be honest I haven’t felt much like doing those things much.<o:p></o:p></div><div class="MsoNormal">B6: Well, as homework for this week I’m going to suggest you commit to one activity each day. What are you going to do today?<o:p></o:p></div><div class="MsoNormal">J7: (<i>Smiles)<o:p></o:p></i></div><div class="MsoNormal">B7: I’m glad to see you smiling. Are you thinking of something enjoyable you are planning to do?<o:p></o:p></div><div class="MsoNormal">J8; No, I was thinking of that old Sinead O’Connor song, “Nothing Compares to you”. Remember the line “<span class="apple-style-span">went to the doctor …he said girl you better try to have fun no matter what you do</span><br /><span class="apple-style-span">but he's a fool.”<o:p></o:p></span></div><div class="MsoNormal">B8 (a bit annoyed) It’s not foolish to ask you to do more – there’s a lot of evidence that backs it up!<o:p></o:p></div><div class="MsoNormal">J9: (smiling again) And does everyone get better when given a dose of your CBT medicine?<o:p></o:p></div><div class="MsoNormal">B9: No, of course not, not everybody, there are exceptions …<o:p></o:p></div><div class="MsoNormal">J10: &nbsp;The hopeless cases, right. Well look at me&nbsp; - old, unemployable, broken marriage –ready &nbsp;for the scrapheap of life. Best save your medicine for a less hopeless case, don’t you think, doc?<o:p></o:p></div><div class="MsoNormal"><br /></div><div class="MsoNormal"></div><div class="MsoNormal" style="background-color: white; color: #666666; font-family: 'Trebuchet MS', Trebuchet, Verdana, sans-serif; font-size: 13px; line-height: 18px;"><b>Can you see what is wrong with counsellor B's approach?</b></div><div class="MsoNormal" style="background-color: white; color: #666666; font-family: 'Trebuchet MS', Trebuchet, Verdana, sans-serif; font-size: 13px; line-height: 18px;"><b><br /></b></div><div class="MsoNormal" style="background-color: white; color: #666666; font-family: 'Trebuchet MS', Trebuchet, Verdana, sans-serif; font-size: 13px; line-height: 18px;"><b>What tips would you give him or her?</b></div></div><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
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http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2012/06/how-not-to-do-cbt-part-2.htmlnoreply@blogger.com (Tim LeBon)2tag:blogger.com,1999:blog-4642274826047849093.post-2063613096971821229Sun, 10 Jun 2012 21:19:00 +00002012-06-10T22:19:40.314+01:00CBTdepressionhow to do CBTskillsHow Not to do CBT - part 1It's far from true to say that CBT is just about applying a few techniques. In fact, good CBT requires a lot of knowledge and a lot of skills, including the ability to put these all together when in the company of a client.<div>In this article series I will be sharing some ideas about how to do CBT - and first, how not to do CBT, with a hypothetical client, "John". &nbsp;Hopefully it will be useful.</div><div><br /></div><div><blockquote class="tr_bq"><span style="font-family: Arial, Helvetica, sans-serif;">John comes to CBT because of his depression.&nbsp; He is a 40 year old who has recently been made redundant. He is worried about getting a job again and his redundancy has also&nbsp; caused tension in his marriage. When questioned about how he spends his time now, he says he gets up late, intends to look for jobs but ends up doing very little. He feels demotivated, discouraged and, at times, hopeless.&nbsp; He is having trouble sleeping and hints that he may be using drinking to cope with his difficulties.&nbsp; At times, he says, he wonders if he will ever get a job again.&nbsp; He sees his redundancy as meaning that he is a failure.&nbsp; He talks in&nbsp; a flat, slow monotone. As he talks, he is becoming more sad and more hopeless.</span></blockquote></div><div><br /></div><div><div class="MsoNormal" style="margin-left: 36.0pt; text-indent: 36.0pt;"><b><u>How NOT to do CBT: &nbsp; Counsellor/Therapist &nbsp;A with "John"<o:p></o:p></u></b></div><div class="MsoNormal"><br /></div><div class="MsoNormal">A1: <i>(In a very empathic tone).</i> Good to see you again, John , how has your week been?<o:p></o:p></div><div class="MsoNormal">J1: Well, up and down.<o:p></o:p></div><div class="MsoNormal">A2: <i>(Sits in silence, waiting for more)<o:p></o:p></i></div><div class="MsoNormal">J2: I still haven’t got a job. I still waste most of my time.&nbsp; I still think I’m a waste of space ….<o:p></o:p></div><div class="MsoNormal">A3: Sounds like it’s been a tough week.<o:p></o:p></div><div class="MsoNormal">J3: To be honest, I’m not sure if this counselling is helping.&nbsp; I wasn’t sure whether to come, but my wife insisted. (<i>Sits in silence)<o:p></o:p></i></div><div class="MsoNormal">A4: So you weren’t sure whether it was worth you coming or not?<o:p></o:p></div><div class="MsoNormal">J4: Well, I’m not better yet, am I?<o:p></o:p></div><div class="MsoNormal">A5:&nbsp; I’m really sorry that you aren’t feeling much better. What’s the main thing that’s been on your mind?<o:p></o:p></div><div class="MsoNormal">J5: I don’t see any prospects of getting work. I’m not getting any younger, the economy is getting worse. Be honest, would you employ a sick 40 year old if you could take on a healthy, cheaper 30 year old?&nbsp; My mate Dave said “treat it like a holiday” but I’m telling you, it’s no holiday.&nbsp; Or if it is, it’s a holiday from hell. My wife hardly talks to me, except to make digs at me.&nbsp; I just don’t see any future.<o:p></o:p></div><div class="MsoNormal">A6: <i>(increasingly feeling engulfed in John’s depressed mood)</i> I can see why you do feel hopeless. <o:p></o:p></div><div class="MsoNormal"><i>Silence<o:p></o:p></i></div><div class="MsoNormal">A7 (<i>Remembering they are meant to be doing CBT not general counselling)</i> I can see it is all looking hopeless now, but sometimes when people are depressed they think in rather extreme and unhelpful ways. It’s like putting on a pair of glasses that filters out all the good things. Do you think that might be happening to you?<o:p></o:p></div><div class="MsoNormal">J6: I suppose so.<o:p></o:p></div><div class="MsoNormal">A8: So, what would it be like for us right now to try on a pair of more rose-tinted spectacles and see what your life might look like?<o:p></o:p></div><div class="MsoNormal">J7: Right, like in those self-help books – “think yourself to happiness!” (<i>Smiles ironically).</i>No thanks, tried that.&nbsp; I’m afraid with me the situation really is bleak it’s not just my thinking.&nbsp; Maybe I was right after all in thinking that this approach isn’t going to help me.<o:p></o:p></div><div class="MsoNormal"><b><br /></b></div><div class="MsoNormal"><b>Can you see what is wrong with counsellor A's approach?</b></div><div class="MsoNormal"><b><br /></b></div><div class="MsoNormal"><b>What tips would you give him or her?</b></div></div><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
Visit http://www.timlebon.com/consultations.htm
Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2012/06/how-not-to-do-cbt-part-1.htmlnoreply@blogger.com (Tim LeBon)0tag:blogger.com,1999:blog-4642274826047849093.post-4985287069990733836Sun, 20 May 2012 07:46:00 +00002015-11-13T16:35:59.434+00:00agenda settingbeckcase conceptualisationCBT for personailty disorderscore beliefsformulationJudith Becklow self-esteemschemastherapeutic alliance10 things I learnt from Judith Beck workshop on CBT for Personality DisordersI attended an excellent workshop given by Judith Beck on <b>CBT for <a href="http://en.wikipedia.org/wiki/Personality_disorder" target="_blank">Personality Disorders</a></b> in London last week. It was a really engaging workshop, with a good mix of lecture, videos and demonstration. The group was large but not overwhelmingly so, meaning that there was a reasonable amount of time for questions. Despite her eminence (Judith is the daughter of Aaron T. Beck and the author of several books including the classic <a href="http://www.amazon.co.uk/Cognitive-Therapy-Aaron-T-Beck/dp/0898628474" target="_blank"><i>Cognitive Therapy: Basics and Beyond</i></a>) she came across as humble and approachable as well as extremely knowledgable.<br /><br />I'm writing this blog entry to share 10 things I learnt or was reminded of in the workshop.<br /><br /><b>1) How to set an agenda in CBT</b><br />Agenda setting is very important in CBT. Like in a meeting at work, having a clear idea of what you want to talk about helps you prioritise and focus collaboratively. However, some therapists find that asking formulaic questions such as "What shall we talk about today?" or "What agenda items do you have?" is either too vague or too formal. Beck shared with us that she no longer tends to ask "What shall we put on the agenda?" but asks the more concrete "What problem or problems would you like my help in solving today?" or "What can we look at today that will help you in the next week?". I like those questions, and have already added them to my set of&nbsp; standard agenda-setting questions with a positive result.<br /><br />2) There are <b>three main areas of core beliefs one can have about oneself, </b>relating to <i>helplessness, unloveability</i> and <i>worthlessness</i>. I think this this is a useful set of categories. Less direct ways clients might express this are, respectively "I can't cope", "If people knew the real me they wouldn't care for me" and "I am nothing".Being aware of these three categories can help you be aware of a particualr clients main vulnerability. Of course, the three areas are not completely exhaustive (for example where do you put the client who says "I am broken"?) and <a href="http://www.schematherapy.com/" target="_blank">Jeffrey Young's</a> idea of lifetraps in <i>Reinventing Your Life</i> contains a&nbsp; <a href="http://www.schematherapy.com/id73.htm" target="_blank">longer list of areas of concern</a>, which also go beyond core beliefs or schemas about onself.<br /><br />3) <a href="http://gandalwaven.typepad.com/intheroom/2006/09/case_conceptual.html" target="_blank">Judith Beck's template for formulation</a> or case conceptualisation is a useful tool to use for clients with personality disorders.&nbsp; It differs from&nbsp; some <a href="http://cbtfortherapists.blogspot.co.uk/2009/10/cbt-formulation-case-conceptualisation.html" target="_blank">other CBT case conceptualisation </a>templates in that it includes compensatory strategies and has room for an example of how it plays out in a situation with automatic thoughts and&nbsp; their meaning (often a core belief) and reaction (often a behaviour).Here is an <a href="http://example./">example</a> in Word format.<br /><br />4) The idea of a <b>compensatory strategy</b> is that people understably behaviour people carry out to get round their core beliefs and assumptions. For example, someone who believes that other people are hostile might have a compensatory strategy of avoiding them or of being a people-pleaser. For those familiar with <a href="http://apt.rcpsych.org/content/4/5/296.full.pdf" target="_blank">Melanie Fennell's model of low self-esteem, </a>it's quite similar to her&nbsp; notion of "unhelpful behaviours".<br /><br />5) A normalising and compassionate way of<b> helping those with personality disorders to understand their compensatory strategies</b>&nbsp; is in terms of <b>overdeveloped</b> and <b>underdeveloped s</b>trategies. For example, someone with <a href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001938/" target="_blank">Obsessive Compulsive&nbsp; Personality Disorder </a>may have overdeveloped responsibility and systematisation (<a href="http://www.padesky.com/" target="_blank">Christine Padesky</a> calls this "too much of a good thing") and undeveloped spontaneity and impulsivity.<br /><br />6)<a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1852259/" target="_blank"><b>CBT can help those with personality disorders</b> </a>but CBT will tend to take longer and more attention needs to be given to developing and maintaining the therapeutic alliance and to developing alternative more helpful core beliefs.<br /><br />7) To help <b>maintain a good therapeutic alliance</b>, Judith Beck's tips include<br /><ul><li>asking for feedback (e.g. on a scale of 1 to 10 how empathic was I, what would have made it one point higher?),&nbsp;</li><li>helping with solving problems relevant to client (see 1 above), l</li><li>looking out for signs of emotional distress in session and bring them to attention of client,&nbsp;</li><li>giving a&nbsp; rationale for your treatment,&nbsp;</li><li>using your formulation&nbsp;</li></ul><div><br /></div>8) Be on the lookout for<b> your own negative reactions to clients with personality disorders</b>, and deal with them, for example by<br /><ul><li>looking at your own core beliefs being activated and looking after yourself (Beck said that she herself finds mindfulness helpful) and&nbsp;</li><li>using supervisions (of course!).&nbsp;</li><li>Above all, expect interpersonal issues to arise - that's why there here - and use the therapy room as a laboratory for helping the client resolve them.</li></ul><br />9. <span style="color: black; font-size: x-small;"><span style="font-family: &quot;verdana&quot; , sans-serif; font-size: x-small;"><a href="http://www2.blogger.com/blogger.g?blogID=4642274826047849093" style="font-family: Arial,Helvetica,sans-serif;" target="_blank">"We don’t see things as they are, we see things as we are</a><span style="font-family: &quot;arial&quot; , &quot;helvetica&quot; , sans-serif;">."</span> </span></span>Strongly held <a href="http://www.google.co.uk/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=2&amp;ved=0CGUQFjAB&amp;url=http%3A%2F%2Fwww.cci.health.wa.gov.au%2Fdocs%2FACF3B8A.pdf&amp;ei=4Zy4T7CLGMWu8QPGmKzDCg&amp;usg=AFQjCNFXsG0ngFAkL_0CYzHwpO921Zt8Ww&amp;sig2=h1OoqD7w6CEXNqr34GdObQ" target="_blank">core beliefs </a>or <a href="http://gad.about.com/od/treatment/a/cbt.htm" target="_blank">schemas</a> filter out our experience in a certain way. For example,&nbsp; if you think you are unloveable, you will look out for things which support this view and either fail to notice or discount examples where you appear to be lovable. Oxford-based therapists Fennell, Butler and Hackmann&nbsp; refer to this process as the "<a href="http://www.getselfhelp.co.uk/docs/MentalCrusher.pdf" target="_blank">mental crushe</a>r." In Judith Beck's version of this idea , you might draw a diagram showing the client's mind with space for a circle, representing an&nbsp; existing core belief. Contradictory core beliefs are then shown as&nbsp; squares or triangles. You can then ask the client "what do you think will happen when you come across an idea that doesn't fit?".&nbsp; This can help clients be prepared for how difficult it may be for them to change their core beliefs but also that they could benefit from being more flexible in how they see themselves and the world. This sets the scene for numerous ways to modify unhelpful core beliefs.<br /><br />10. There are a number of ways to modify core beliefs. I have <a href="http://www.timlebon.com/corebeliefs.html" target="_blank">written elsewhere</a> about many of these. Beck adds to my list of <a href="http://www.timlebon.com/corebeliefs.html" target="_blank">10 ways to change core beliefs by adding</a><br /><ul><li>&nbsp; using metaphors and stories (e.g. Cinderalla story for how someone can overcome abuse) and</li><li>&nbsp;restructuring the meaning of early experiences through imagery, </li></ul>All in all it was very refreshing to hear how you could deal with more complex cases in CBT without departing too much from standard CBT practice. Whilst approaches such as Schema Therapy and&nbsp; Dialectical Behaviour Therapy may seem very attractive to those who have tried CBT for those with personality disorders without success, Beck's approach suggests that such a radical change in approach may not always be necessary.<br /><br />I hope this list of 10 things I learnt from the workshop gives some flavour of how CBT can help with Personality Disorders and more generally with working with more complex clients. Of course, there was much more in the workshop than is summarised above, and I thoroughly recommend you go to one of Judith Beck's workshops if you get the chance. <br /><br /><b>Further resources</b><br /><a href="http://www.beckinstitute.org/" target="_blank">Beck Institute&nbsp; </a>Website<b> </b><br /><a href="http://www.psychologytoday.com/blog/in-therapy/200902/seven-questions-judith-beck" target="_blank">Interview </a>with Judith Beck<br />Judith Beck <a href="http://www.google.co.uk/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=13&amp;ved=0CKABELcCMAw&amp;url=http%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3D45U1F7cDH5k&amp;ei=pMy3T5-KEYiQ8QOJ_YTECg&amp;usg=AFQjCNFSPjQvtoiqLzwjfVnlpLsiryfE_w&amp;sig2=_nV-h8BDorSCj_JnCGKv6w" target="_blank">video</a> on You Tube<div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
Visit http://www.timlebon.com/consultations.htm
Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2012/05/10-things-i-learnt-from-judith-beck.htmlnoreply@blogger.com (Tim LeBon)4tag:blogger.com,1999:blog-4642274826047849093.post-755617045806989529Sat, 18 Feb 2012 16:24:00 +00002012-02-18T16:24:47.690+00:00behavioural experimentsdepressionfree cbt resourcesCBT for Depression - a brief overview of treatment with free resourcesAccording to the <a href="http://www2.blogger.com/http://www.nice.org.uk/nicemedia/pdf/CG90NICEguideline.pdf" target="_blank">NICE Guidelines</a>, CBT is one of the most evidence-based treatments of choice for (unipolar) depression.&nbsp; In this short article I will describe how a CBT therapist might treat depression in&nbsp; a course of therapy, giving links to free off-site depression resources.<br /><br />In an assessment, the therapist will screen for depression, possibly using the<a href="http://www.depression-primarycare.org/clinicians/toolkits/materials/forms/phq9/" target="_blank"> PHQ-9</a> amongst other measures to assess the level of depression and <a href="http://www.medicinenet.com/script/main/art.asp?articlekey=55172" target="_blank">assess risk</a>. The clinician will explain the rationale and basics of CBT for depression, often giving a <a href="http://www.choosehelp.com/depression/cognitive-behavioral-therapy-cbt-for-depression" target="_blank">handout on CBT for depression</a> for the client to read as homework. The might also recommend<a href="http://media.wiley.com/product_data/excerpt/00/07645390/0764539000.pdf" target="_blank"> self-help books</a> to read about depression.<br /><br />In the first session the therapist will start by setting an agenda, which will include reviewing the homework and starting a simple formulation of the client's depression. This may well include helping the client see if they are in a <a href="http://www.cci.health.wa.gov.au/resources/docs/Info-Vicious%20Cycle%20of%20Depression.pdf" target="_blank">vicious cycle of depression</a>, where low mood leads&nbsp; low energy and fatigue,&nbsp; leading to decreased activity and neglect of duties, feelings of guilt and hopelessness and increased depression ... The first intervention may well be activity monitoring and <a href="http://www.goodmedicine.org.uk/files/depression,%20activity%20schedule%20I.DOC" target="_blank">activity scheduling</a>.&nbsp; This will allow the therapist and client to see how active or inactive they have become and also to identify possible activities that will give them either some pleasure or sense of achievement that will lift their mood and start moving them into a virtuous cycle.<br />Later sessions will include cognitive restructuring, challenging negative automatic thoughts using a <a href="http://www.getselfhelp.co.uk/docs/DepressionThoughtRecordSheet.pdf" target="_blank">thought record.</a><br />Other inteventions may include<a href="http://londoncognitive.com/2011/08/10/brief-problem-solving-therapy-pst-strategies/" target="_blank"> problem-solving</a> and <a href="http://cbtfortherapists.blogspot.com/2012/02/cbt-and-behavioural-experiments.html" target="_blank">behavioural experiments.&nbsp;</a><br />For example, a behavioural experiment may test out some dysfunctional assumptions that are maintaining the clients depression - e.g. "if I go out, I won't enjoy myself" or "if I call a friend, they won't wont to speak to me.".&nbsp; In some cases, it may be necessary to try to help unhelpful schemas and<a href="http://cbtfortherapists.blogspot.com/2010/10/changing-core-beliefs-using-cbt.html" target="_blank"> negative core beliefs.</a><br /><br />In the final sessions, a blueprint will be created to <a href="http://heretohelp.bc.ca/skills/managing-depression/relapse" target="_blank">manage relapse </a><br /><br /><br /><b>Recommended Links - free resouces for CBT of Depression</b><br /><br /><br /><a href="http://www.moodjuice.scot.nhs.uk/depression.asp" target="_blank">Very Good self-help guide from MoodJuice</a><br /><br />Excellent handout on <a href="http://www.cci.health.wa.gov.au/resources/docs/Info-Vicious%20Cycle%20of%20Depression.pdf" target="_blank">Vicious Cycle of Depression </a><br /><br />NICE guidelines on depression (<a href="http://www.nice.org.uk/nicemedia/pdf/G90NICEguideline.pdf" target="_blank">2009 64 page PDF)</a><br />NICE <a href="http://www.nice.org.uk/nicemedia/live/12329/45890/45890.pdf" target="_blank">quick reference guide</a> on depression <br /><br />WORD version of <a href="http://www.goodmedicine.org.uk/files/depression,%20activity%20schedule%20I.DOC" target="_blank">Activity Scheduling</a> - grid and tips<br /><br /><a href="http://www.getselfhelp.co.uk/docs/DepressionThoughtRecordSheet.pdf" target="_blank">Thought Record</a> for Depression<br /><br /><a href="http://www.choosehelp.com/depression/cognitive-behavioral-therapy-cbt-for-depression" target="_blank">Simple explanation </a>of CBT for depression<br /><br /><a href="http://www.depression-primarycare.org/clinicians/toolkits/materials/forms/phq9/" target="_blank">PHQ-9</a> - Free Patient Health Questionnaire frequently used in NHS as quick and easy way to measure depression <br /><br />First Chapter of <a href="http://media.wiley.com/product_data/excerpt/00/07645390/0764539000.pdf" target="_blank">"Depression for Dummies"</a><br /><h1 id="article-title-1" style="font-family: inherit; font-weight: normal;"><span style="font-size: small;"><a href="http://apt.rcpsych.org/content/9/1/21.full" target="_blank">The evidence base for cognitive–behavioural therapy in depression: delivery in busy clinical settings</a> - full 2003 article</span></h1><h1 id="article-title-1" style="font-family: inherit; font-weight: normal;"><span style="font-size: small;"><a href="http://www.mrc-cbu.cam.ac.uk/research/emotion/cemhp/documents/kuyken_cbt_depression.pdf" target="_blank">2007 review</a> of evidence for CBT for depression</span></h1><br /><br /><br /><br /><br /><br /><br /><a href="http://www.clinicalpsychology.ro/en/educationalresearch-materials-for-professionals/ctcbt-depression-manual-protocol/" target="_blank">Useful CBT/REBT manual for clinicians for depression</a><br /><a href="http://www2.blogger.com/http://www.aafp.org/afp/2006/0101/p83.html">Short article expalining CBT for depression</a><br /><br /><a href="http://www.aafp.org/afp/2006/0101/p90.html" target="_blank">Short handout for clients on CBT for depression</a><br /><br />Good article on <a href="http://londoncognitive.com/2011/08/10/brief-problem-solving-therapy-pst-strategies/" target="_blank">problem-solving therapy</a> which has been shown to be effective for depression<div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
Visit http://www.timlebon.com/consultations.htm
Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2012/02/cbt-for-depression-brief-overview-of.htmlnoreply@blogger.com (Tim LeBon)1tag:blogger.com,1999:blog-4642274826047849093.post-8782628823911903407Sat, 11 Feb 2012 14:21:00 +00002012-02-11T14:21:59.665+00:00CBTCBT videosWhat is CBTGood short video "What is CBT?" by Robert Leahy<iframe width="420" height="315" src="http://www.youtube.com/embed/gdFovvVJpr8" frameborder="0" allowfullscreen></iframe><div class="blogger-post-footer">Consultations available in central London for help with anxiety, depression, OCD, PTSD, stress, perfectionism low self-esteem, relationship issues and many other problems
Visit http://www.timlebon.com/consultations.htm
Read more at Tim LeBon's CBT in London Site
http://www.timlebon.com/cbt.html</div>http://cbtfortherapists.blogspot.com/2012/02/good-short-video-what-is-cbt-by-robert.htmlnoreply@blogger.com (Tim LeBon)0